The Pines At Placerville Healthcare Center - Placerville Nursing Home
General Information
UPDATEFederal Provider Number
55497
Provider Name
THE PINES AT PLACERVILLE HEALTHCARE CENTER
Provider Address
1040 MARSHALL WAY
PLACERVILLE, CA 95667
PLACERVILLE, CA 95667
Provider Phone Number
(530) 622-3400
Provider SSA County
80
Provider County Name
El Dorado
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
89
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GLADIOLUS HOLDINGS, LLC
Date First Approved to Provide Medicare and Medicaid services
1976-07-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.29663
Reported LPN Staffing Hours per Resident per Day
0.89213
Reported RN Staffing Hours per Resident per Day
0.47697
Reported Licensed Staffing Hours per Resident per Day
1.36910
Reported Total Nurse Staffing Hours per Resident per Day
3.66573
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07360
Expected CNA Staffing Hours per Resident per Day
2.55043
Expected LPN Staffing Hours per Resident per Day
0.61467
Expected RN Staffing Hours per Resident per Day
1.01705
Expected Total Nurse Staffing Hours per Resident per Day
4.18215
Adjusted CNA Staffing Hours per Resident per Day
2.20952
Adjusted LPN Staffing Hours per Resident per Day
1.20466
Adjusted RN Staffing Hours per Resident per Day
0.35042
Adjusted Total Nurse Staffing Hours per Resident per Day
3.53315
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2015-04-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2014-04-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2013-04-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
25.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
1
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
1
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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