Villa Siena - Mountain View Nursing Home
General Information
UPDATEFederal Provider Number
05A364
Provider Name
VILLA SIENA
Provider Address
1855 MIRAMONTE AVENUE
MOUNTAIN VIEW, CA 94040
MOUNTAIN VIEW, CA 94040
Provider Phone Number
(650) 961-6484
Provider SSA County
530
Provider County Name
Santa Clara
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
30
Number of Residents in Certified Beds
27
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1986-09-03
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
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
3.17407
Reported LPN Staffing Hours per Resident per Day
0.92037
Reported RN Staffing Hours per Resident per Day
0.70926
Reported Licensed Staffing Hours per Resident per Day
1.62963
Reported Total Nurse Staffing Hours per Resident per Day
4.80370
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06667
Expected CNA Staffing Hours per Resident per Day
2.45295
Expected LPN Staffing Hours per Resident per Day
0.53083
Expected RN Staffing Hours per Resident per Day
0.76112
Expected Total Nurse Staffing Hours per Resident per Day
3.74491
Adjusted CNA Staffing Hours per Resident per Day
3.17504
Adjusted LPN Staffing Hours per Resident per Day
1.43908
Adjusted RN Staffing Hours per Resident per Day
0.69628
Adjusted Total Nurse Staffing Hours per Resident per Day
5.17055
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-06-17
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
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-06-27
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
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-06-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
21.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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