Villa Pomerado D/p Snf - Poway Nursing Home
General Information
UPDATEFederal Provider Number
555301
Provider Name
VILLA POMERADO D/P SNF
Provider Address
15615 POMERADO RD
POWAY, CA 92064
POWAY, CA 92064
Provider Phone Number
(858) 613-4545
Provider SSA County
470
Provider County Name
San Diego
Provider Website
Provider Description
Ownership Type
Government - Hospital district
Number of Certified Beds
129
Number of Residents in Certified Beds
125
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
PALOMAR HEALTH
Date First Approved to Provide Medicare and Medicaid services
1988-05-05
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
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
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
2.37160
Reported LPN Staffing Hours per Resident per Day
1.01480
Reported RN Staffing Hours per Resident per Day
1.35800
Reported Licensed Staffing Hours per Resident per Day
2.37280
Reported Total Nurse Staffing Hours per Resident per Day
4.74440
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10920
Expected CNA Staffing Hours per Resident per Day
2.39449
Expected LPN Staffing Hours per Resident per Day
0.84856
Expected RN Staffing Hours per Resident per Day
1.34888
Expected Total Nurse Staffing Hours per Resident per Day
4.59193
Adjusted CNA Staffing Hours per Resident per Day
2.43024
Adjusted LPN Staffing Hours per Resident per Day
0.99260
Adjusted RN Staffing Hours per Resident per Day
0.75225
Adjusted Total Nurse Staffing Hours per Resident per Day
4.16474
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-12-10
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
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-12-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2013-01-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
42.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
2
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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