Wagner Heights Nursing & Rehab - Stockton Nursing Home

General Information

UPDATE
Federal Provider Number
555470
Provider Name
WAGNER HEIGHTS NURSING & REHAB
Provider Address
9289 BRANSTETTER PLACE
STOCKTON, CA 95209
Provider Phone Number
(209) 477-5252
Provider SSA County
490
Provider County Name
San Joaquin
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
152
Number of Residents in Certified Beds
141
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COVENANT CARE CALIFORNIA, LLC
Date First Approved to Provide Medicare and Medicaid services
1991-06-19
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
2
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
2.24220
Reported LPN Staffing Hours per Resident per Day
0.75426
Reported RN Staffing Hours per Resident per Day
0.77695
Reported Licensed Staffing Hours per Resident per Day
1.53121
Reported Total Nurse Staffing Hours per Resident per Day
3.77341
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07695
Expected CNA Staffing Hours per Resident per Day
2.63134
Expected LPN Staffing Hours per Resident per Day
0.77286
Expected RN Staffing Hours per Resident per Day
1.25942
Expected Total Nurse Staffing Hours per Resident per Day
4.66362
Adjusted CNA Staffing Hours per Resident per Day
2.09083
Adjusted LPN Staffing Hours per Resident per Day
0.81002
Adjusted RN Staffing Hours per Resident per Day
0.46096
Adjusted Total Nurse Staffing Hours per Resident per Day
3.26146
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
9
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2014-10-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
8
Cycle 2 Health Deficiency Score
92
Cycle 2 Standard Health Survey Date
2013-10-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
92
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
7
Cycle 3 Health Deficiency Score
76
Cycle 3 Standard Health Survey Date
2012-10-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
76
Total Weighted Health Survey Score
77.33300
Number of Facility Reported Incidents
9
Number of Substantiated Complaints
13
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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