Providence Sun Villa - Porterville Nursing Home
General Information
UPDATEFederal Provider Number
55551
Provider Name
PROVIDENCE SUN VILLA
Provider Address
350 NORTH VILLA STREET
PORTERVILLE, CA 93257
PORTERVILLE, CA 93257
Provider Phone Number
(559) 784-6644
Provider SSA County
640
Provider County Name
Tulare
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
96
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PROVIDENCE HEALTH CARE OF SUN VILLA LLC
Date First Approved to Provide Medicare and Medicaid services
1978-02-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.81042
Reported LPN Staffing Hours per Resident per Day
1.00313
Reported RN Staffing Hours per Resident per Day
0.29427
Reported Licensed Staffing Hours per Resident per Day
1.29740
Reported Total Nurse Staffing Hours per Resident per Day
4.10782
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06406
Expected CNA Staffing Hours per Resident per Day
2.19430
Expected LPN Staffing Hours per Resident per Day
0.57915
Expected RN Staffing Hours per Resident per Day
0.85618
Expected Total Nurse Staffing Hours per Resident per Day
3.62963
Adjusted CNA Staffing Hours per Resident per Day
3.14265
Adjusted LPN Staffing Hours per Resident per Day
1.43762
Adjusted RN Staffing Hours per Resident per Day
0.25681
Adjusted Total Nurse Staffing Hours per Resident per Day
4.56195
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
132
Cycle 1 Standard Survey Health Date
2015-03-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
132
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-02-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
26
Cycle 3 Number of Standard Health Deficiencies
22
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
200
Cycle 3 Standard Health Survey Date
2013-03-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
200
Total Weighted Health Survey Score
99.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
2
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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