Springs Road Healthcare - Vallejo Nursing Home
General Information
UPDATEFederal Provider Number
55222
Provider Name
SPRINGS ROAD HEALTHCARE
Provider Address
1527 SPRINGS ROAD
VALLEJO, CA 94591
VALLEJO, CA 94591
Provider Phone Number
(707) 643-2793
Provider SSA County
580
Provider County Name
Solano
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
65
Number of Residents in Certified Beds
53
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EVERGREEN AT SPRINGS ROAD, L.L.C.
Date First Approved to Provide Medicare and Medicaid services
1974-01-01
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
3
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.10566
Reported LPN Staffing Hours per Resident per Day
0.43302
Reported RN Staffing Hours per Resident per Day
1.09434
Reported Licensed Staffing Hours per Resident per Day
1.52736
Reported Total Nurse Staffing Hours per Resident per Day
3.63302
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08774
Expected CNA Staffing Hours per Resident per Day
2.54157
Expected LPN Staffing Hours per Resident per Day
0.59261
Expected RN Staffing Hours per Resident per Day
1.01545
Expected Total Nurse Staffing Hours per Resident per Day
4.14963
Adjusted CNA Staffing Hours per Resident per Day
2.03286
Adjusted LPN Staffing Hours per Resident per Day
0.60648
Adjusted RN Staffing Hours per Resident per Day
0.80525
Adjusted Total Nurse Staffing Hours per Resident per Day
3.52907
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2015-03-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
197
Cycle 2 Standard Health Survey Date
2014-03-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
197
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2013-07-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
89.66700
Number of Facility Reported Incidents
4
Number of Substantiated Complaints
0
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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