Pacific Rehabilitation & Wellness Center, Lp
2211 Harrison Avenue, Eureka, CA 95501


Pacific Rehabilitation & Wellness Center, Lp is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 055334. The address is 2211 Harrison Avenue, Eureka, CA 95501. The zip code is 95501. The phone number is 7074439767.


Pacific Rehabilitation & Wellness Center, Lp · 2211 Harrison Avenue, Eureka, CA 95501

Federal Provider Number 055334
Provider Name PACIFIC REHABILITATION & WELLNESS CENTER, LP
Address 2211 HARRISON AVENUE
EUREKA, CA 95501
Phone Number 7074439767
SSA County Code 110
County Name Humboldt
Ownership Type For profit - Partnership
Certified Beds 60
Certified Beds Residents 50
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name PACIFIC REHABILITATION & WELLNESS CENTER, LP
Date First Approved to Provide Medicare Medicaid Services 01/01/1967
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating Footnote Rating Not Displayed
Health Inspection Rating 3
Quality Measure Rating 3
Staffing Rating Footnote Rating Not Displayed
RN Staffing Rating Footnote Rating Not Displayed
Reported CNA Staffing Hours per Resident per Day 2.534
Reported LPN Staffing Hours per Resident per Day 0.73
Reported RN Staffing Hours per Resident per Day 0.704
Reported Licensed Staffing Hours per Resident per Day 1.434
Reported Total Nurse Staffing Hours per Resident per Day 3.968
Reported Physical Therapist Staffing Hours per Resident Per Day 0.06
Expected CNA Staffing Hours per Resident per Day 2.36041
Expected LPN Staffing Hours per Resident per Day 0.59619
Expected RN Staffing Hours per Resident per Day 0.88162
Expected Total Nurse Staffing Hours per Resident per Day 3.83821
Adjusted CNA Staffing Hours per Resident per Day 2.63415
Adjusted LPN Staffing Hours per Resident per Day 1.01629
Adjusted RN Staffing Hours per Resident per Day 0.59666
Adjusted Total Nurse Staffing Hours per Resident per Day 4.1672
Cycle 1 Total Number of Health Deficiencies 10
Cycle 1 Number of Standard Health Deficiencies 10
Cycle 1 Health Deficiency Score 80
Cycle 1 Standard Survey Health Date 12/11/2015
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 80
Cycle 2 Standard Health Survey Date 06/05/2015
Cycle 3 Total Number of Health Deficiencies 14
Cycle 3 Number of Standard Health Deficiencies 14
Cycle 3 Health Deficiency Score 100
Cycle 3 Standard Health Survey Date 05/16/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 100
Total Weighted Health Survey Score 56.667
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Pacific Rehabilitation & Wellness Center, Lp

Owner Name Role Association Date
KOLODNY, CHAIM (Individual) MANAGING EMPLOYEE since 04/01/2011
KUPPERMANN, ALAIN (Individual) PARTNERSHIP INTEREST since 04/01/2011
PACIFIC WELLNESS GP LLC (Organization) PARTNERSHIP INTEREST since 04/01/2011
RECHNITZ, SHLOMO (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 04/01/2011

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