St Johns Pleasant Valley Hospital D/p Snf - Camarillo Nursing Home
General Information
UPDATEFederal Provider Number
555223
Provider Name
ST JOHNS PLEASANT VALLEY HOSPITAL D/P SNF
Provider Address
2309 ANTONIO AVE
CAMARILLO, CA 93010
CAMARILLO, CA 93010
Provider Phone Number
(805) 389-5853
Provider SSA County
660
Provider County Name
Ventura
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
44
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
DIGNITY HEALTH
Date First Approved to Provide Medicare and Medicaid services
1986-04-17
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.81818
Reported LPN Staffing Hours per Resident per Day
4.05227
Reported RN Staffing Hours per Resident per Day
1.55909
Reported Licensed Staffing Hours per Resident per Day
5.61136
Reported Total Nurse Staffing Hours per Resident per Day
9.42954
Reported Physical Therapist Staffing Hours per Resident Per Day
0.26023
Expected CNA Staffing Hours per Resident per Day
2.82862
Expected LPN Staffing Hours per Resident per Day
1.39534
Expected RN Staffing Hours per Resident per Day
1.82499
Expected Total Nurse Staffing Hours per Resident per Day
6.04895
Adjusted CNA Staffing Hours per Resident per Day
3.31209
Adjusted LPN Staffing Hours per Resident per Day
2.41045
Adjusted RN Staffing Hours per Resident per Day
0.63833
Adjusted Total Nurse Staffing Hours per Resident per Day
6.28366
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-09-02
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
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-09-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-09-25
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
20.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
6
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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