Willow Creek Healthcare Center - Clovis Nursing Home
General Information
UPDATEFederal Provider Number
555652
Provider Name
WILLOW CREEK HEALTHCARE CENTER
Provider Address
650 W. ALLUVIAL
CLOVIS, CA 93611
CLOVIS, CA 93611
Provider Phone Number
5593236200
Provider SSA County
90
Provider County Name
Fresno
Ownership Type
For profit - Individual
Number of Certified Beds
159
Number of Residents in Certified Beds
138
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WILLOW CREEK HEALTHCARE CENTER, LLC
Date First Approved to Provide Medicare and Medicaid services
1996-02-08
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
2.26449
Reported LPN Staffing Hours per Resident per Day
0.68370
Reported RN Staffing Hours per Resident per Day
0.87174
Reported Licensed Staffing Hours per Resident per Day
1.55543
Reported Total Nurse Staffing Hours per Resident per Day
3.81993
Reported Physical Therapist Staffing Hours per Resident Per Day
0.15326
Expected CNA Staffing Hours per Resident per Day
2.28584
Expected LPN Staffing Hours per Resident per Day
0.59905
Expected RN Staffing Hours per Resident per Day
1.06833
Expected Total Nurse Staffing Hours per Resident per Day
3.95322
Adjusted CNA Staffing Hours per Resident per Day
2.43078
Adjusted LPN Staffing Hours per Resident per Day
0.94728
Adjusted RN Staffing Hours per Resident per Day
0.60970
Adjusted Total Nurse Staffing Hours per Resident per Day
3.89499
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-11-07
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-11-22
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-11-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
40.00000
Number of Facility Reported Incidents
5
Number of Substantiated Complaints
5
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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