Wolf Creek Care Center
107 Catherine Lane, Grass Valley, CA 95945


Wolf Creek Care Center is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 055512. The address is 107 Catherine Lane, Grass Valley, CA 95945. The zip code is 95945. The phone number is 5302734447.


Wolf Creek Care Center · 107 Catherine Lane, Grass Valley, CA 95945

Federal Provider Number 055512
Provider Name WOLF CREEK CARE CENTER
Address 107 CATHERINE LANE
GRASS VALLEY, CA 95945
Phone Number 5302734447
SSA County Code 390
County Name Nevada
Ownership Type For profit - Corporation
Certified Beds 59
Certified Beds Residents 55
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name BLUEBELL HOLDINGS, LLC
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 2
Health Inspection Rating 2
Quality Measure Rating 4
Staffing Rating 2
RN Staffing Rating 4
Reported CNA Staffing Hours per Resident per Day 1.69
Reported LPN Staffing Hours per Resident per Day 0.34455
Reported RN Staffing Hours per Resident per Day 0.67909
Reported Licensed Staffing Hours per Resident per Day 1.02364
Reported Total Nurse Staffing Hours per Resident per Day 2.71364
Expected CNA Staffing Hours per Resident per Day 2.28325
Expected LPN Staffing Hours per Resident per Day 0.57773
Expected RN Staffing Hours per Resident per Day 0.87222
Expected Total Nurse Staffing Hours per Resident per Day 3.73321
Adjusted CNA Staffing Hours per Resident per Day 1.81616
Adjusted LPN Staffing Hours per Resident per Day 0.495
Adjusted RN Staffing Hours per Resident per Day 0.58175
Adjusted Total Nurse Staffing Hours per Resident per Day 2.93003
Cycle 1 Total Number of Health Deficiencies 19
Cycle 1 Number of Standard Health Deficiencies 16
Cycle 1 Number of Complaint Health Deficiencies 3
Cycle 1 Health Deficiency Score 120
Cycle 1 Standard Survey Health Date 11/04/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 120
Cycle 2 Total Number of Health Deficiencies 1
Cycle 2 Number of Standard Health Deficiencies 1
Cycle 2 Health Deficiency Score 8
Cycle 2 Standard Health Survey Date 10/15/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 8
Cycle 3 Total Number of Health Deficiencies 12
Cycle 3 Number of Standard Health Deficiencies 9
Cycle 3 Number of Complaint Health Deficiencies 12
Cycle 3 Health Deficiency Score 68
Cycle 3 Standard Health Survey Date 08/28/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 68
Total Weighted Health Survey Score 74
Number of Facility Reported Incidents 3
Number of Substantiated Complaints 3
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Wolf Creek Care Center

Owner Name Role Association Date
ALLPRO, INC. (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2015
ANDERSON, NICKLAS (Individual) OFFICER since 01/15/2017
ANDERSON, NICKLAS (Individual) OPERATIONAL/MANAGERIAL CONTROL since 01/15/2017
AUBURN MANOR HOLDING CORP (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2015
BAY BRIDGE CAPITAL PARTNERS, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2015
CALIFORNIA OPCO LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 11/01/2014
CROSSWINDS TRUST (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2015
CUNLIFFE, JOSEPH (Individual) OFFICER since 06/01/2013
FLOWER FARM GROUP, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/07/2012
HAKIM, NAVEED (Individual) OFFICER since 01/15/2017
HAKIM, NAVEED (Individual) OPERATIONAL/MANAGERIAL CONTROL since 01/15/2017
HEALTHCARE FINANCIAL SOLUTIONS, LLC (Organization) 5% OR GREATER MORTGAGE INTEREST since 11/30/2015
HORIZON WEST HEALTHCARE, INC. (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2015
NEW SISU HOLDCO, LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 06/07/2011
NEW SISU HOLDCO, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2015
OPCO HOLDINGS LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2015
PLUM HEALTHCARE GROUP, LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 06/07/2011
PUGH, PHYLLIS (Individual) OFFICER since 08/01/2013
PUGH, PHYLLIS (Individual) OPERATIONAL/MANAGERIAL CONTROL since 08/01/2013

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