Balboa Nursing & Rehabilitation Center - San Diego Nursing Home
General Information
UPDATEFederal Provider Number
56105
Provider Name
BALBOA NURSING & REHABILITATION CENTER
Provider Address
3520 FOURTH AVENUE
SAN DIEGO, CA 92103
SAN DIEGO, CA 92103
Provider Phone Number
(619) 291-5270
Provider SSA County
470
Provider County Name
San Diego
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
194
Number of Residents in Certified Beds
167
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BALBOA HEALTHCARE, INC.
Date First Approved to Provide Medicare and Medicaid services
1969-10-10
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
5
Overall Rating Footnote
Health Inspection Rating
3
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
2.93922
Reported LPN Staffing Hours per Resident per Day
0.91707
Reported RN Staffing Hours per Resident per Day
1.12186
Reported Licensed Staffing Hours per Resident per Day
2.03892
Reported Total Nurse Staffing Hours per Resident per Day
4.97815
Reported Physical Therapist Staffing Hours per Resident Per Day
0.15629
Expected CNA Staffing Hours per Resident per Day
2.69001
Expected LPN Staffing Hours per Resident per Day
0.67309
Expected RN Staffing Hours per Resident per Day
1.04673
Expected Total Nurse Staffing Hours per Resident per Day
4.40983
Adjusted CNA Staffing Hours per Resident per Day
2.68102
Adjusted LPN Staffing Hours per Resident per Day
1.13086
Adjusted RN Staffing Hours per Resident per Day
0.80083
Adjusted Total Nurse Staffing Hours per Resident per Day
4.55038
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-06-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-07-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-07-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
48.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
2
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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