Villa Mesa Care Center - Upland Nursing Home
General Information
UPDATEFederal Provider Number
56136
Provider Name
VILLA MESA CARE CENTER
Provider Address
867 E. 11TH STREET
UPLAND, CA 91786
UPLAND, CA 91786
Provider Phone Number
(909) 985-1981
Provider SSA County
460
Provider County Name
San Bernardino
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
92
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SELA HEALTHCARE INC
Date First Approved to Provide Medicare and Medicaid services
1972-06-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
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
2.44565
Reported LPN Staffing Hours per Resident per Day
0.92120
Reported RN Staffing Hours per Resident per Day
0.40543
Reported Licensed Staffing Hours per Resident per Day
1.32663
Reported Total Nurse Staffing Hours per Resident per Day
3.77228
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06304
Expected CNA Staffing Hours per Resident per Day
2.53970
Expected LPN Staffing Hours per Resident per Day
0.64032
Expected RN Staffing Hours per Resident per Day
0.99033
Expected Total Nurse Staffing Hours per Resident per Day
4.17034
Adjusted CNA Staffing Hours per Resident per Day
2.36284
Adjusted LPN Staffing Hours per Resident per Day
1.19409
Adjusted RN Staffing Hours per Resident per Day
0.30590
Adjusted Total Nurse Staffing Hours per Resident per Day
3.64615
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-10-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
80
Cycle 2 Standard Health Survey Date
2014-01-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
80
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2013-01-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
52.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
4
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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