The legal business name is Legal Business Name Not Available. This facility was first approved to provide Medicare and Medicaid services on 04/15/1986. It does not belong to a continuing care retirement community. The affiliated entity name is not listed. This facility has No Family Council.
The overall rating is 2 stars, with a health inspection rating of 3 stars, a quality measures rating of 1 stars, a long-stay QM rating of 1 stars, a short-stay QM rating of N/A stars, and a staffing rating of 4 stars.
The reported total nurse staffing hours per resident per day is 5 hours and 48 minutes, nurse aide staffing hours is 3 hours and 21 minutes, LPN staffing hours is 1 hours and 17 minutes, RN staffing hours is 1 hours and 10 minutes, and licensed staffing hours is 2 hours and 27 minutes. On weekends, total nurse staff hours per resident per day is 5 hours and 27 minutes, and registered nurse hours per resident per day is 1 hours and 12 minutes. Physical therapist staffing hours per resident per day are 1 minutes.
The facility has reported 11 facility-related incidents, 1 substantiated complaints, no citations from infection control inspections, and 8 fines, with the total amount of fines in dollars being $31,498. The number of payment denials is 0, and the total number of penalties is 8.
| Surprise Valley Community Hospital D/P Snf Phone: (530) 279-6111 |
| Surprise Valley Community Hospital D/P Snf Address: 741 N. Main Street |
| City: Cedarville |
| State: CA |
| ZIP Code: 96104 |
| County: Modoc |
| Overall Rating | |
| Health Inspection Rating | |
| QM Rating | |
| Long-Stay QM Rating | |
| Short-Stay QM Rating | |
| Staffing Rating |
| Number of Certified Beds | 22 |
| Average Number of Residents per Day | 21.6 |
| Legal Business Name | Legal Business Name Not Available |
| Affiliated Entity Name | |
| Ownership Type | For profit – Corporation |
| Provider Type | Medicare and Medicaid |
| Provider Resides in Hospital | Y |
| Legal Business Name | Legal Business Name Not Available |
| Date First Approved to Provide Medicare and Medicaid Services | 4/15/1986 |
| Affiliated Entity Name | |
| Continuing Care Retirement Community | N |
| Most Recent Health Inspection More Than 2 Years Ago | N |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | None |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Reported Total Nurse Staffing Hours per Resident per Day | 5 hours 48 minutes |
| Reported Nurse Aide Staffing Hours per Resident per Day | 3 hours 21 minutes |
| Reported LPN Staffing Hours per Resident per Day | 1 hour 17 minutes |
| Reported RN Staffing Hours per Resident per Day | 1 hour 10 minutes |
| Reported Licensed Staffing Hours per Resident per Day | 2 hours 27 minutes |
| Total number of nurse staff hours per resident per day on the weekend | 5 hours 27 minutes |
| Registered Nurse hours per resident per day on the weekend | 1 hour 12 minutes |
| Reported Physical Therapist Staffing Hours per Resident Per Day | 1 minute 24 seconds |
| Number of Facility Reported Incidents | 11 |
| Number of Substantiated Complaints | 1 |
| Number of Citations from Infection Control Inspections | |
| Number of Fines | 8 |
| Total Amount of Fines in Dollars | $31,498 |
| Number of Payment Denials | 0 |
| Total Number of Penalties | 8 |
* Data is based on CMS Nursing homes including rehab services dataset.