| Country Villa Hacienda Healthcare Center | |
| 1311 East Date Street, San Bernardino, California 92404 | |
| (909) 882-3316 | |
| Name | Country Villa Hacienda Healthcare Center |
|---|---|
| Location | 1311 East Date Street, San Bernardino, California |
| Certified By | Medicare and Medicaid |
| No. of Certified Beds | 99 |
| Occupancy Rate | 81.62% |
| Medicare ID (CCN) | 056053 |
| Legal Business Name | Mountainside Operating Company, Llc |
| Ownership Type | For Profit - Individual |
| NPI Number | 1427457233 |
| Organization Name | HACIENDA HEIGHTS HEALTHCARE & WELLNESS CENTRE, LP |
| Address | 1311 E Date St, San Bernardino, CA 92404 |
| Phone Number | 909-882-3316 |
| NPI Number | 1477547750 |
| Organization Name | MOUNTAINSIDE OPERATING COMPANY, LLC |
| Doing Business As | COUNTRY VILLA HACIENDA HEALTHCARE CENTER |
| Address | 1311 E Date St, San Bernardino, CA 92404 |
| Phone Number | 909-882-3316 |
| NPI Number | 1629653720 |
| Organization Name | HAVEN POST ACUTE LLC |
| Address | 1311 E Date St, San Bernardino, CA 92404 |
| Phone Number | 909-882-3316 |
| Ratings from Surveys (Inspections): | |
| Ratings from Quality Measures: | |
| Ratings from Staffing Data: | |
| Overall Rating: |
|---|
| Number of Facility Reported Incidents | 0 |
| Number of Substantiated Complaints | 0 |
| Number of Fines | 1 |
| Total Amount of Fines in Dollars | $12275 |
| Number of Payment Denials | 0 |
| Total Number of Penalties | 1 |
| Experience Measure | Provider | National Avg. |
|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased | 8.75 | 14.46 |
| Percentage of long-stay residents who lose too much weight | 1.69 | 5.51 |
| Percentage of low risk long-stay residents who lose control of their bowels or bladder | 7.89 | 48.41 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 2.68 | 1.79 |
| Percentage of long-stay residents with a urinary tract infection | 0.75 | 2.65 |
| Percentage of long-stay residents who have depressive symptoms | 86.14 | 5.05 |
| Percentage of long-stay residents who were physically restrained | 0 | 0.23 |
| Percentage of long-stay residents experiencing one or more falls with major injury | 0.34 | 3.36 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 100 | 93.87 |
| Percentage of long-stay residents who received an antipsychotic medication | 5.35 | 14.2 |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 100 | 83.88 |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0 | 1.79 |
| Percentage of long-stay residents whose ability to move independently worsened | 12.96 | 17.09 |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 12.64 | 19.7 |
| Percentage of high risk long-stay residents with pressure ulcers | 10.17 | 7.32 |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 99.12 | 95.98 |
| Percentage of short-stay residents who made improvements in function | 86.53 | 67.99 |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 97.37 | 82.93 |
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Country Villa Hacienda Healthcare Center Location: 1311 East Date Street, San Bernardino, California 92404 Phone: (909) 882-3316 | |
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