Providence Valley Care Center
661 West Poplar, Porterville, CA 93257


Providence Valley Care Center is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 056423. The address is 661 West Poplar, Porterville, CA 93257. The zip code is 93257. The phone number is 5597848371.


Providence Valley Care Center · 661 West Poplar, Porterville, CA 93257

Federal Provider Number 056423
Provider Name PROVIDENCE VALLEY CARE CENTER
Address 661 WEST POPLAR
PORTERVILLE, CA 93257
Phone Number 5597848371
SSA County Code 640
County Name Tulare
Ownership Type For profit - Corporation
Certified Beds 62
Certified Beds Residents 58
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name PROVIDENCE HEALTH CARE OF VALLEY CARE CENTER LLC
Date First Approved to Provide Medicare Medicaid Services 12/21/1973
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 3
Health Inspection Rating 2
Quality Measure Rating 5
Staffing Rating 3
RN Staffing Rating 1
Reported CNA Staffing Hours per Resident per Day 3.21207
Reported LPN Staffing Hours per Resident per Day 1.29052
Reported RN Staffing Hours per Resident per Day 0.35603
Reported Licensed Staffing Hours per Resident per Day 1.64655
Reported Total Nurse Staffing Hours per Resident per Day 4.85862
Reported Physical Therapist Staffing Hours per Resident Per Day 0.11552
Expected CNA Staffing Hours per Resident per Day 2.41913
Expected LPN Staffing Hours per Resident per Day 0.59031
Expected RN Staffing Hours per Resident per Day 0.95177
Expected Total Nurse Staffing Hours per Resident per Day 3.96121
Adjusted CNA Staffing Hours per Resident per Day 3.25798
Adjusted LPN Staffing Hours per Resident per Day 1.81451
Adjusted RN Staffing Hours per Resident per Day 0.27951
Adjusted Total Nurse Staffing Hours per Resident per Day 4.94409
Cycle 1 Total Number of Health Deficiencies 16
Cycle 1 Number of Standard Health Deficiencies 16
Cycle 1 Health Deficiency Score 92
Cycle 1 Standard Survey Health Date 07/28/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 92
Cycle 2 Total Number of Health Deficiencies 9
Cycle 2 Number of Standard Health Deficiencies 8
Cycle 2 Number of Complaint Health Deficiencies 1
Cycle 2 Health Deficiency Score 44
Cycle 2 Standard Health Survey Date 08/13/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 44
Cycle 3 Total Number of Health Deficiencies 9
Cycle 3 Number of Standard Health Deficiencies 7
Cycle 3 Number of Complaint Health Deficiencies 5
Cycle 3 Health Deficiency Score 60
Cycle 3 Standard Health Survey Date 09/18/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 60
Total Weighted Health Survey Score 70.667
Number of Facility Reported Incidents 3
Number of Substantiated Complaints 1
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Providence Valley Care Center

Owner Name Role Association Date
FUNK, KENNETH (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2016
FUNK, KENNETH (Individual) DIRECTOR since 03/24/2014
HANCOCK, MARK (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2016
HANCOCK, MARK (Individual) DIRECTOR since 03/24/2014
HANCOCK, MARK (Individual) OFFICER since 03/24/2014
HANCOCK, MARK (Individual) OPERATIONAL/MANAGERIAL CONTROL since 03/24/2014
MURRAY, JASON (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2016
MURRAY, JASON (Individual) DIRECTOR since 03/24/2014
MURRAY, JASON (Individual) OFFICER since 03/24/2014
MURRAY, JASON (Individual) OPERATIONAL/MANAGERIAL CONTROL since 03/24/2014
PROVIDENCE GROUP INC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/24/2014
PROVIDENCE GROUP OF CALIFORNIA LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/24/2014
PROVIDENCE HEALTH CARE OF VALLEY CARE CENTER LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 03/24/2014
SHORT, ALAN (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2016
SHORT, ALAN (Individual) DIRECTOR since 03/24/2014
SHORT, ALAN (Individual) OFFICER since 03/24/2014
SHORT, ALAN (Individual) OPERATIONAL/MANAGERIAL CONTROL since 03/24/2014
SMITH, RAMON (Individual) MANAGING EMPLOYEE since 05/01/2014
SMITH, RAMON (Individual) OPERATIONAL/MANAGERIAL CONTROL since 05/01/2014

93257 · Nursing Home

Porterville Developmental Center 26501 Avenue 140, Porterville, CA 93257
Sierra View Medical Center 465 W Putnam Ave, Porterville, CA 93257
Porterville Convalescent Hospital 1100 West Morton Avenue, Porterville, CA 93257
Sierra Valley Rehab Center 301 West Putnam, Porterville, CA 93257
Providence Sun Villa 350 North Villa Street, Porterville, CA 93257

Porterville · Nursing Home

Sierra View Medical Center 465 W Putnam Ave, Porterville, CA 93257
Porterville Developmental Center 26501 Avenue 140, Porterville, CA 93257
Porterville Convalescent Hospital 1100 West Morton Avenue, Porterville, CA 93257
Providence Sun Villa 350 North Villa Street, Porterville, CA 93257
Sierra Valley Rehab Center 301 West Putnam, Porterville, CA 93257

CA · Nursing Home

Sherman Oaks Hospital Snf Dp 4929 Van Nuys Blvd, Sherman Oaks, CA 91403
Mountains Community Hosp Dpsnf 29101 Hospital Road, Lake Arrowhead, CA 92352
Grace Healthcare of Moraga 348 Rheem Boulevard, Moraga, CA 94556
Driftwood Healthcare Center - Hayward 19700 Hesperian Boulevard, Hayward, CA 94541
Thousand Oaks Healthcare Center 93 W Avenida De Los Arboles, Thousand Oaks, CA 91360
Windsor Gardens Rehabilitation Center of Salinas 637 East Romie Lane, Salinas, CA 93901
Dos Palos Memorial Skilled Nursing Facility 2118 Marguerite St, Dos Palos, CA 93620
Sierra View Homes 1155 E. Springfield Avenue, Reedley, CA 93654
Katherine Healthcare 315 Alameda Avenue, Salinas, CA 93901
Garden View Post- Acute Rehabilitation 14475 Garden View Lane, Baldwin Park, CA 91706
Lakeside Special Care Center 11962 Woodside Avenue, Lakeside, CA 92040
Pine Creek Care Center 1139 Cirby Way, Roseville, CA 95661
Lawndale Healthcare & Wellness Centre LLC 15100 S Prairie, Lawndale, CA 90260
Autumn Hills Health Care Center 430 N.glendale Ave, Glendale, CA 91206
Greenfield Care Center of Fullerton, LLC 330 W. Bastanchury Road, Fullerton, CA 92835
Hayes Convalescent Hospital 1250 Hayes Street, San Francisco, CA 94117
Parkview Healthcare Center 329 North Real Road, Bakersfield, CA 93309
Centinela Skilled Nursing & Wellness Centre West 950 Flower Street, Inglewood, CA 90301
Vista Cove Care Center At Santa Paula 250 March St, Santa Paula, CA 93060
Life Care Center of Escondido 1980 Felicita Road, Escondido, CA 92025
Carmel Hills Care Center 23795 W. R. Holman Highway, Monterey, CA 93940
Laurel Convalescent Hospital 7509 N Laurel Ave, Fontana, CA 92336
Maple Healthcare Center 2526 Maple Ave., Los Angeles, CA 90011
Country Villa Bay Vista Hcc 5901 Downey Ave, Long Beach, CA 90805
Grand Valley Health Care Center 13524 Sherman Way, Van Nuys, CA 91405
Stollwood Convalescent Hospital 135 Woodland Avenue, Woodland, CA 95695
Woodside Healthcare Center 2240 Northrop Ave, Sacramento, CA 95825
Windsor Vallejo Nursing & Rehabilitation Center 2200 Tuolumne Street, Vallejo, CA 94589
Joyce Eisenberg Keefer Medical Center D/p Snf 7150 Tampa Avenue, Reseda, CA 91335
Hayward Hills Health Care Center 1768 B Street, Hayward, CA 94541
Alameda Healthcare & Wellness Center 430 Willow Street, Alameda, CA 94501
Glendale Healthcare Center 1208 S. Central Ave, Glendale, CA 91204
Fountain Care Center 1835 West La Veta Avenue, Orange, CA 92868
Danville Rehabilitation 336 Diablo Road, Danville, CA 94526
Modesto Post Acute Center 159 E. Orangeburg Avenue, Modesto, CA 95350
New Orange Hills 5017 E. Chapman Avenue, Orange, CA 92869
Manning Gardens Care Center, Inc 2113 E. Manning Avenue, Fresno, CA 93725
Sharp Chula Vista Med Ctr Snf 751 Medical Center Court, Chula Vista, CA 91911
Brookdale Rancho Mirage 72-201 Country Club Drive, Rancho Mirage, CA 92270
Eisenhower Healthcare Center 1470 N Fair Oaks Ave, Pasadena, CA 91103