Villa Monte Vista - Poway Nursing Home
General Information
UPDATEFederal Provider Number
555206
Provider Name
VILLA MONTE VISTA
Provider Address
12696 MONTE VISTA ROAD
POWAY, CA 92064
POWAY, CA 92064
Provider Phone Number
(858) 487-6242
Provider SSA County
470
Provider County Name
San Diego
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
149
Number of Residents in Certified Beds
138
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1985-07-26
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
2.59964
Reported LPN Staffing Hours per Resident per Day
0.63514
Reported RN Staffing Hours per Resident per Day
0.55036
Reported Licensed Staffing Hours per Resident per Day
1.18551
Reported Total Nurse Staffing Hours per Resident per Day
3.78514
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06196
Expected CNA Staffing Hours per Resident per Day
2.51340
Expected LPN Staffing Hours per Resident per Day
0.57916
Expected RN Staffing Hours per Resident per Day
0.82222
Expected Total Nurse Staffing Hours per Resident per Day
3.91479
Adjusted CNA Staffing Hours per Resident per Day
2.53789
Adjusted LPN Staffing Hours per Resident per Day
0.91022
Adjusted RN Staffing Hours per Resident per Day
0.50014
Adjusted Total Nurse Staffing Hours per Resident per Day
3.89741
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2014-07-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
80
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-08-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
18
Cycle 3 Number of Standard Health Deficiencies
17
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
88
Cycle 3 Standard Health Survey Date
2012-10-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
88
Total Weighted Health Survey Score
65.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
5
Number of Fines
2
Total Amount of Fines in Dollars
8450
Number of Payment Denials
1
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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