Amberwood Gardens - San Jose Nursing Home

General Information

UPDATE
Federal Provider Number
55750
Provider Name
AMBERWOOD GARDENS
Provider Address
1601 PETERSEN AVENUE
SAN JOSE, CA 95129
Provider Phone Number
4082537502
Provider SSA County
530
Provider County Name
Santa Clara
Ownership Type
For profit - Corporation
Number of Certified Beds
258
Number of Residents in Certified Beds
243
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WESTGATE PREMIER HEALTHCARE SERVICES, INC.
Date First Approved to Provide Medicare and Medicaid services
1978-07-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
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
3.13251
Reported LPN Staffing Hours per Resident per Day
1.12840
Reported RN Staffing Hours per Resident per Day
1.69218
Reported Licensed Staffing Hours per Resident per Day
2.82058
Reported Total Nurse Staffing Hours per Resident per Day
5.95309
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12881
Expected CNA Staffing Hours per Resident per Day
2.71338
Expected LPN Staffing Hours per Resident per Day
0.77094
Expected RN Staffing Hours per Resident per Day
1.08174
Expected Total Nurse Staffing Hours per Resident per Day
4.56606
Adjusted CNA Staffing Hours per Resident per Day
2.83272
Adjusted LPN Staffing Hours per Resident per Day
1.21484
Adjusted RN Staffing Hours per Resident per Day
1.16886
Adjusted Total Nurse Staffing Hours per Resident per Day
5.25536
Cycle 1 Total Number of Health Deficiencies
22
Cycle 1 Number of Standard Health Deficiencies
18
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
104
Cycle 1 Standard Survey Health Date
2015-01-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
104
Cycle 2 Total Number of Health Deficiencies
22
Cycle 2 Number of Standard Health Deficiencies
22
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
124
Cycle 2 Standard Health Survey Date
2014-03-17
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
17
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
116
Cycle 3 Standard Health Survey Date
2013-04-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
116
Total Weighted Health Survey Score
112.66700
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
6
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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