Village At Northrise (the) - Desert Willow I
2884 North Road Runner Parkway, Las Cruces, NM 88011


Village At Northrise (the) - Desert Willow I is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 325111. The address is 2884 North Road Runner Parkway, Las Cruces, NM 88011. The zip code is 88011. The phone number is 5755221110.


Village At Northrise (the) - Desert Willow I · 2884 North Road Runner Parkway, Las Cruces, NM 88011

Federal Provider Number 325111
Provider Name VILLAGE AT NORTHRISE (THE) - DESERT WILLOW I
Address 2884 NORTH ROAD RUNNER PARKWAY
LAS CRUCES, NM 88011
Phone Number 5755221110
SSA County Code 60
County Name Dona Ana
Ownership Type For profit - Corporation
Certified Beds 30
Certified Beds Residents 25
Provider Type Medicare
Resides in Hospital false
Legal Business Name PEAK MEDICAL ASSISTED LIVING LLC
Date First Approved to Provide Medicare Medicaid Services 01/08/2001
Continuing Care Retirement Community true
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 4
Health Inspection Rating 3
Quality Measure Rating 3
Staffing Rating 4
RN Staffing Rating 3
Reported CNA Staffing Hours per Resident per Day 0.006
Reported LPN Staffing Hours per Resident per Day 4.438
Reported RN Staffing Hours per Resident per Day 1.19
Reported Licensed Staffing Hours per Resident per Day 5.628
Reported Total Nurse Staffing Hours per Resident per Day 5.634
Reported Physical Therapist Staffing Hours per Resident Per Day 0.6
Expected CNA Staffing Hours per Resident per Day 2.20011
Expected LPN Staffing Hours per Resident per Day 0.76489
Expected RN Staffing Hours per Resident per Day 1.81401
Expected Total Nurse Staffing Hours per Resident per Day 4.77901
Adjusted CNA Staffing Hours per Resident per Day 0.00669
Adjusted LPN Staffing Hours per Resident per Day 4.81579
Adjusted RN Staffing Hours per Resident per Day 0.49017
Adjusted Total Nurse Staffing Hours per Resident per Day 4.75205
Cycle 1 Total Number of Health Deficiencies 12
Cycle 1 Number of Standard Health Deficiencies 5
Cycle 1 Number of Complaint Health Deficiencies 7
Cycle 1 Health Deficiency Score 132
Cycle 1 Standard Survey Health Date 09/14/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 132
Cycle 2 Total Number of Health Deficiencies 2
Cycle 2 Number of Complaint Health Deficiencies 2
Cycle 2 Health Deficiency Score 16
Cycle 2 Standard Health Survey Date 07/09/2015
Cycle 2 Total Health Score 16
Cycle 3 Total Number of Health Deficiencies 3
Cycle 3 Number of Standard Health Deficiencies 3
Cycle 3 Health Deficiency Score 20
Cycle 3 Standard Health Survey Date 07/17/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 20
Total Weighted Health Survey Score 74.667
Number of Substantiated Complaints 3
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Village At Northrise (the) - Desert Willow I

Owner Name Role Association Date
BERG, MICHAEL (Individual) OFFICER since 03/02/2015
BERG, MICHAEL (Individual) OPERATIONAL/MANAGERIAL CONTROL since 03/02/2015
DAVIS, KEITH (Individual) OPERATIONAL/MANAGERIAL CONTROL since 03/02/2015
DONNA REIS 1995 FAM TR (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
EDWARDS, JAN (Individual) OFFICER since 03/02/2015
FC-GEN OPERATIONS INVESTMENT LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012
FISHMAN, STEVEN (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
GEN OPERATIONS I LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012
GEN OPERATIONS II, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012
GENERAL ELECTRIC CAPITAL CORPORATION (Organization) 5% OR GREATER SECURITY INTEREST since 12/01/2012
GENESIS HEALTHCARE INC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
GENESIS HEALTHCARE LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
GENESIS HEALTHCARE LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 12/01/2012
GENESIS HOLDINGS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
HCCF MANAGEMENT GROUP XI LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
MISTRETTA, CASSIE (Individual) OFFICER since 02/01/2017
ONEX PARTNERS LP (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
PEAK MEDICAL LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 02/02/2015
SANCHEZ, GREG (Individual) OFFICER since 03/02/2015
SENIOR CARE GENESIS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
SENIOR CARE HOLDINGS, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
SHERMAN, MICHAEL (Individual) OFFICER since 12/01/2012
SUN HEALTHCARE GROUP, INC. (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
SUNBRIDGE HEALTHCARE LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 04/20/2007
SUNDANCE REHABILITATION HOLDCO, INC. (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 01/01/2016
WHITMAN, ARNOLD (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
WILSON, DONALD (Individual) MANAGING EMPLOYEE since 03/21/2017
ZAC PROPERTIES XI LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015

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