Plymouth Square - Stockton Nursing Home
General Information
UPDATEFederal Provider Number
555692
Provider Name
PLYMOUTH SQUARE
Provider Address
1319 N. MADISON STREET
STOCKTON, CA 95202
STOCKTON, CA 95202
Provider Phone Number
2094664341
Provider SSA County
490
Provider County Name
San Joaquin
Ownership Type
Non profit - Church related
Number of Certified Beds
38
Number of Residents in Certified Beds
31
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
STOCKTON CONGREGATIONAL HOMES
Date First Approved to Provide Medicare and Medicaid services
1997-02-01
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
Partial
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.25323
Reported LPN Staffing Hours per Resident per Day
1.04839
Reported RN Staffing Hours per Resident per Day
0.59032
Reported Licensed Staffing Hours per Resident per Day
1.63871
Reported Total Nurse Staffing Hours per Resident per Day
3.89194
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06452
Expected CNA Staffing Hours per Resident per Day
2.39582
Expected LPN Staffing Hours per Resident per Day
0.62684
Expected RN Staffing Hours per Resident per Day
0.87640
Expected Total Nurse Staffing Hours per Resident per Day
3.89906
Adjusted CNA Staffing Hours per Resident per Day
2.30767
Adjusted LPN Staffing Hours per Resident per Day
1.38818
Adjusted RN Staffing Hours per Resident per Day
0.50329
Adjusted Total Nurse Staffing Hours per Resident per Day
4.02354
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-12-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-01-23
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2013-01-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
10.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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
Nursiong Homes Nearby
Lincoln Square Post Acute Care
1032 N. Lincoln Street |
STOCKTON CA 95203 | 0.3 mile away
Good Samaritan Rehab And Care Center
1630 N. Edison Street |
STOCKTON CA 95204 | 0.4 mile away
Windsor Hampton Care Center
442 Hampton Street |
STOCKTON CA 95204 | 0.7 mile away
Golden Living Center - Portside
2740 North California Street |
STOCKTON CA 95204 | 1 mile away
La Salette Health And Rehabilitation Center
537 E. Fulton Street |
STOCKTON CA 95204 | 1.4 miles away
Golden Living Center - Hy-pana
4545 Shelley Court |
STOCKTON CA 95207 | 1.9 miles away
Golden Living Center - Chateau
1221 Rosemarie Lane |
STOCKTON CA 95207 | 2 miles away
Crestwood Manor - 104
1130 Monaco Court |
STOCKTON CA 95207 | 2 miles away
Riverwood Healthcare Center
5320 Carrington Circle |
STOCKTON CA 95210 | 2.8 miles away
Windsor Elmhaven Care Center
6940 Pacific Avenue |
STOCKTON CA 95207 | 3.6 miles away
Kindred Transitional Care & Rehab - Valley Gardens
1517 East Knickerbocker Drive |
STOCKTON CA 95210 | 4.1 miles away
Wagner Heights Nursing & Rehab
9289 Branstetter Place |
STOCKTON CA 95209 | 5.5 miles away
Meadowood A Health And Rehabilitation Center
3110 Wagner Heights Road |
STOCKTON CA 95209 | 5.6 miles away
Creekside Center
9107 N. Davis Road |
STOCKTON CA 95209 | 7.4 miles away
Delta Rehabilitation And Care Center
1334 S. Ham Lane |
LODI CA 95242 | 10.4 miles away
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