Contact Information

PROVIDENCE WATERMAN
WATERMANIDENCE OPCO LLC
1850 N. WATERMAN AVE.
SAN BERNARDINO, CA 92404
(909) 882-1215
For profit - Corporation
Medicare certification date2: January 01, 1971
The is the date the nursing home was certified to participate in the Medicare program.

1 Nursing homes can be run by private for-profit corporations, non-profit corporations, religious affiliated organizations or government entities.

2 Agencies that are Medicare Certified are able to participate in Medicare related programs.


Nursing Home Information

  157 residents

  166 certified beds

  Participates in Medicare and Medicaid

  Continuing Care Retirement Community

  In hospital

  Resident Council only

  Automatic sprinklers in all required areas

Quality rating
Health inspection rating
Staffing rating
Substantiated complaints 15
Facility reported incidents 8
Number of fines 1
Number of penalties 1
Number of payment denials None

Staffing

Staffing for 157 residents California Average National Average
Hours by Registered Nurse (RN) per resident per day 12 minutes 37 minutes 41 minutes
Hours by Licensed Practial Nurse (LPN & LVN) per resident per day 1 hour, 6 minutes 1 hour, 8 minutes 53 minutes
Hours by Certified Nursing Assistant (CNA) per resident per day 2 hours, 11 minutes 2 hours, 29 minutes 2 hours, 20 minutes
Physical therapy (PT) staff hours per resident per day 3 minutes 8 minutes 7 minutes

Staffing hours per resident is the total number of hours worked by the staff divided by the total number of residents. It doesn't necessarily show the number of nursing staff present at any given time or the amount of care given to any one resident.

Ownership

5% OR GREATER DIRECT OWNERSHIP INTEREST

  • PROVIDENCE GROUP OF SOUTHERN CALIFORNIA LLC

5% OR GREATER INDIRECT OWNERSHIP INTEREST

  • PROVIDENCE GROUP INC
  • FUNK, KENNETH
  • HANCOCK, MARK
  • MURRAY, JASON
  • SHORT, ALAN

DIRECTOR

  • FUNK, KENNETH
  • HANCOCK, MARK
  • SHORT, ALAN

MANAGING EMPLOYEE

  • CIOFFI, NICOLETTA

OFFICER

  • FUNK, KENNETH
  • HANCOCK, MARK
  • MURRAY, JASON
  • SHORT, ALAN

OPERATIONAL/MANAGERIAL CONTROL

  • HANCOCK, MARK
  • MURRAY, JASON

Nursing Home Report

In 2016, PROVIDENCE WATERMAN charged a total of $881,604 for 58 Medicare Beneficiaries. The average age of residents at this skilled nursing facility is about 69.

The report covers only calendar year 2016.

Chronic Condition of Residents
Atrial Fibrillation 14% Alzheimer's 47%
Asthma 45% Cancer 5%
Congestive Heart Failure 55% Kidney Disease 66%
COPD 48% Depression 48%
Diabetes 55% Hyperlipidemia 71%
Hypertension n/a Ischemic Heart Disease 66%
Osteoporosis 9% RA / OA 47%
Schizophrenia 17% Stroke 26%
Demographics
Medicare Beneficiaries 58 Average Age 69
Male 38 Female 20
White 25
Black 15
Asian n/a
Hispanic 14
American Indian 0
Other n/a

Health & Fire Inspection

Most recent health inspection: Mar 01, 2018; fire safety inspection: Apr 19, 2018

Health Deficiencies as of 03/01/2018
Freedom from Abuse, Neglect, and Exploitation None
Quality of Life and Care None
Resident Assessment and Care Planning 2
Nursing and Physician Services None
Resident Rights 2
Nutrition and Dietary Deficiencies 1
Pharmacy Service 1
Environmental Deficiencies 2
Administration Deficiencies None
Fire Deficiencies as of 04/19/2018
Emergency Preparedness 3
Automatic Sprinkler Systems None
Construction Deficiencies None
Services Deficiencies None
Corridor Walls and Doors None
Egress Deficiencies None
Electrical Deficiencies None
Emergency Plans and Fire Drills None
Fire Alarm Systems None
Smoke Deficiencies None
Interior Deficiencies None
Gas, Vacuum, and Electrical Systems None
Hazardous Area None
Illumination and Emergency Power None
Laboratories Deficiencies None
Medical Gases and Anesthetizing Areas None
Smoking Regulations None
Miscellaneous Regulations None

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See also