Milpitas Care Center - Milpitas Nursing Home

General Information

UPDATE
Federal Provider Number
555757
Provider Name
MILPITAS CARE CENTER
Provider Address
120 CORNING AVENUE
MILPITAS, CA 95035
Provider Phone Number
4082620217
Provider SSA County
530
Provider County Name
Santa Clara
Ownership Type
For profit - Corporation
Number of Certified Beds
35
Number of Residents in Certified Beds
30
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
UNITED FAMILY MEDICAL SUPPLY, INC.
Date First Approved to Provide Medicare and Medicaid services
2000-06-27
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
0.00000
Reported LPN Staffing Hours per Resident per Day
0.62000
Reported RN Staffing Hours per Resident per Day
1.29500
Reported Licensed Staffing Hours per Resident per Day
1.91500
Reported Total Nurse Staffing Hours per Resident per Day
1.91500
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09500
Expected CNA Staffing Hours per Resident per Day
2.54247
Expected LPN Staffing Hours per Resident per Day
0.64613
Expected RN Staffing Hours per Resident per Day
1.00234
Expected Total Nurse Staffing Hours per Resident per Day
4.19093
Adjusted CNA Staffing Hours per Resident per Day
0.00000
Adjusted LPN Staffing Hours per Resident per Day
0.79644
Adjusted RN Staffing Hours per Resident per Day
0.96537
Adjusted Total Nurse Staffing Hours per Resident per Day
1.84188
Cycle 1 Total Number of Health Deficiencies
17
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2014-10-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
80
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2014-01-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2013-04-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
68.66700
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
0
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01

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