Martinez Convalescent Hospital
4110 Alhambra Way, Martinez, CA 94553


Martinez Convalescent Hospital is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 555821. The address is 4110 Alhambra Way, Martinez, CA 94553. The zip code is 94553. The phone number is 9252284260.


Martinez Convalescent Hospital · 4110 Alhambra Way, Martinez, CA 94553

Federal Provider Number 555821
Provider Name MARTINEZ CONVALESCENT HOSPITAL
Address 4110 ALHAMBRA WAY
MARTINEZ, CA 94553
Phone Number 9252284260
SSA County Code 60
County Name Contra Costa
Ownership Type For profit - Corporation
Certified Beds 36
Certified Beds Residents 31
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name THEKKEK HEALTH SERVICES, INC.
Date First Approved to Provide Medicare Medicaid Services 03/18/2005
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 4
Quality Measure Rating 5
Staffing Rating Footnote Rating Not Displayed
RN Staffing Rating Footnote Rating Not Displayed
Reported CNA Staffing Hours per Resident per Day 3.22097
Reported LPN Staffing Hours per Resident per Day 0.07419
Reported RN Staffing Hours per Resident per Day 0.82903
Reported Licensed Staffing Hours per Resident per Day 0.90323
Reported Total Nurse Staffing Hours per Resident per Day 4.12419
Reported Physical Therapist Staffing Hours per Resident Per Day 0.13871
Expected CNA Staffing Hours per Resident per Day 2.34736
Expected LPN Staffing Hours per Resident per Day 0.51108
Expected RN Staffing Hours per Resident per Day 0.73829
Expected Total Nurse Staffing Hours per Resident per Day 3.59673
Adjusted CNA Staffing Hours per Resident per Day 3.36688
Adjusted LPN Staffing Hours per Resident per Day 0.12049
Adjusted RN Staffing Hours per Resident per Day 0.83904
Adjusted Total Nurse Staffing Hours per Resident per Day 4.62203
Cycle 1 Total Number of Health Deficiencies 4
Cycle 1 Number of Standard Health Deficiencies 1
Cycle 1 Number of Complaint Health Deficiencies 3
Cycle 1 Health Deficiency Score 12
Cycle 1 Standard Survey Health Date 05/27/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 12
Cycle 2 Total Number of Health Deficiencies 11
Cycle 2 Number of Standard Health Deficiencies 11
Cycle 2 Health Deficiency Score 44
Cycle 2 Standard Health Survey Date 04/10/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 44
Cycle 3 Total Number of Health Deficiencies 6
Cycle 3 Number of Standard Health Deficiencies 6
Cycle 3 Health Deficiency Score 36
Cycle 3 Standard Health Survey Date 02/05/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 36
Total Weighted Health Survey Score 26.667
Number of Facility Reported Incidents 2
Number of Substantiated Complaints 2
Number of Fines 1
Total Amount of Fines in Dollars $48269.00
Number of Payment Denials 1
Total Number of Penalties 2
Processing Date 08/01/2017

Owner or Manager · Martinez Convalescent Hospital

Owner Name Role Association Date
THEKKEK, ANTONY (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
50%
since 05/11/1998
THEKKEK, ANTONY (Individual) DIRECTOR since 05/11/1998
THEKKEK, ANTONY (Individual) MANAGING EMPLOYEE since 05/11/1998
THEKKEK, ANTONY (Individual) OFFICER since 05/11/1998
THEKKEK, PREMA (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
50%
since 05/11/1998
THEKKEK, PREMA (Individual) DIRECTOR since 05/11/1998
THEKKEK, PREMA (Individual) MANAGING EMPLOYEE since 05/11/1998
THEKKEK, PREMA (Individual) OFFICER since 05/11/1998

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Martinez · Nursing Home

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