Sierra Vista - Highland Nursing Home
General Information
UPDATEFederal Provider Number
05A027
Provider Name
SIERRA VISTA
Provider Address
3455 EAST HIGHLAND AVE
HIGHLAND, CA 92346
HIGHLAND, CA 92346
Provider Phone Number
(909) 862-6454
Provider SSA County
460
Provider County Name
San Bernardino
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
116
Number of Residents in Certified Beds
114
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1974-03-31
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
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
4
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.94474
Reported LPN Staffing Hours per Resident per Day
0.42719
Reported RN Staffing Hours per Resident per Day
0.36228
Reported Licensed Staffing Hours per Resident per Day
0.78947
Reported Total Nurse Staffing Hours per Resident per Day
2.73421
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
1.26629
Expected LPN Staffing Hours per Resident per Day
0.50691
Expected RN Staffing Hours per Resident per Day
0.52822
Expected Total Nurse Staffing Hours per Resident per Day
2.30142
Adjusted CNA Staffing Hours per Resident per Day
3.76834
Adjusted LPN Staffing Hours per Resident per Day
0.69946
Adjusted RN Staffing Hours per Resident per Day
0.51247
Adjusted Total Nurse Staffing Hours per Resident per Day
4.78892
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
12
Cycle 1 Health Deficiency Score
230
Cycle 1 Standard Survey Health Date
2015-01-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
230
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
7
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2014-02-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
60
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2013-03-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
139.66700
Number of Facility Reported Incidents
18
Number of Substantiated Complaints
10
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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