diff --git a/octodns/provider/route53.py b/octodns/provider/route53.py
index e8b11fa..1516f43 100644
--- a/octodns/provider/route53.py
+++ b/octodns/provider/route53.py
@@ -1250,15 +1250,27 @@ class Route53Provider(BaseProvider):
                        '%s', record.fqdn, record._type)
 
         fqdn = record.fqdn
+        _type = record._type
 
         # loop through all the r53 rrsets
         for rrset in self._load_records(zone_id):
             name = rrset['Name']
+            # Break off the first piece of the name, it'll let us figure out if
+            # this is an rrset we're interested in.
+            maybe_meta, rest = name.split('.', 1)
+
+            if not maybe_meta.startswith('_octodns-') or \
+               not maybe_meta.endswith('-value') or \
+               '-default-' in name:
+                # We're only interested in non-default dynamic value records,
+                # as that's where healthchecks live
+                continue
+
+            if rest != fqdn or _type != rrset['Type']:
+                # rrset isn't for the current record
+                continue
 
-            if record._type == rrset['Type'] and name.endswith(fqdn) and \
-               name.startswith('_octodns-') and '-value.' in name and \
-               '-default-' not in name and \
-               self._extra_changes_update_needed(record, rrset):
+            if self._extra_changes_update_needed(record, rrset):
                 # no good, doesn't have the right health check, needs an update
                 self.log.info('_extra_changes_dynamic_needs_update: '
                               'health-check caused update of %s:%s',
diff --git a/tests/test_octodns_provider_route53.py b/tests/test_octodns_provider_route53.py
index added7f..849ea2b 100644
--- a/tests/test_octodns_provider_route53.py
+++ b/tests/test_octodns_provider_route53.py
@@ -1673,7 +1673,7 @@ class TestRoute53Provider(TestCase):
         desired.add_record(record)
         list_resource_record_sets_resp = {
             'ResourceRecordSets': [{
-                # other name
+                # Not dynamic value and other name
                 'Name': 'unit.tests.',
                 'Type': 'A',
                 'GeoLocation': {
@@ -1683,17 +1683,21 @@ class TestRoute53Provider(TestCase):
                     'Value': '1.2.3.4',
                 }],
                 'TTL': 61,
+                # All the non-matches have a different Id so we'll fail if they
+                # match
+                'HealthCheckId': '33',
             }, {
-                # matching name, other type
+                # Not dynamic value, matching name, other type
                 'Name': 'a.unit.tests.',
                 'Type': 'AAAA',
                 'ResourceRecords': [{
                     'Value': '2001:0db8:3c4d:0015:0000:0000:1a2f:1a4b'
                 }],
                 'TTL': 61,
+                'HealthCheckId': '33',
             }, {
                 # default value pool
-                'Name': '_octodns-default-pool.a.unit.tests.',
+                'Name': '_octodns-default-value.a.unit.tests.',
                 'Type': 'A',
                 'GeoLocation': {
                     'CountryCode': '*',
@@ -1702,6 +1706,37 @@ class TestRoute53Provider(TestCase):
                     'Value': '1.2.3.4',
                 }],
                 'TTL': 61,
+                'HealthCheckId': '33',
+            }, {
+                # different record
+                'Name': '_octodns-two-value.other.unit.tests.',
+                'Type': 'A',
+                'GeoLocation': {
+                    'CountryCode': '*',
+                },
+                'ResourceRecords': [{
+                    'Value': '1.2.3.4',
+                }],
+                'TTL': 61,
+                'HealthCheckId': '33',
+            }, {
+                # same everything, but different type
+                'Name': '_octodns-one-value.a.unit.tests.',
+                'Type': 'AAAA',
+                'ResourceRecords': [{
+                    'Value': '2001:0db8:3c4d:0015:0000:0000:1a2f:1a4b'
+                }],
+                'TTL': 61,
+                'HealthCheckId': '33',
+            }, {
+                # same everything, sub
+                'Name': '_octodns-one-value.sub.a.unit.tests.',
+                'Type': 'A',
+                'ResourceRecords': [{
+                    'Value': '1.2.3.4',
+                }],
+                'TTL': 61,
+                'HealthCheckId': '33',
             }, {
                 # match
                 'Name': '_octodns-one-value.a.unit.tests.',