Berkeley Pines Care Center, Inc - Berkeley Nursing Home
General Information
UPDATEFederal Provider Number
55892
Provider Name
BERKELEY PINES CARE CENTER, INC
Provider Address
2223 ASHBY AVE
BERKELEY, CA 94705
BERKELEY, CA 94705
Provider Phone Number
(510) 649-6670
Provider SSA County
0
Provider County Name
Alameda
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
36
Number of Residents in Certified Beds
36
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BERKELEY PINES CARE CENTER, INC
Date First Approved to Provide Medicare and Medicaid services
1968-02-14
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.61944
Reported LPN Staffing Hours per Resident per Day
0.68056
Reported RN Staffing Hours per Resident per Day
0.44444
Reported Licensed Staffing Hours per Resident per Day
1.12500
Reported Total Nurse Staffing Hours per Resident per Day
3.74444
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00833
Expected CNA Staffing Hours per Resident per Day
2.41384
Expected LPN Staffing Hours per Resident per Day
0.60597
Expected RN Staffing Hours per Resident per Day
0.92463
Expected Total Nurse Staffing Hours per Resident per Day
3.94445
Adjusted CNA Staffing Hours per Resident per Day
2.66269
Adjusted LPN Staffing Hours per Resident per Day
0.93217
Adjusted RN Staffing Hours per Resident per Day
0.35915
Adjusted Total Nurse Staffing Hours per Resident per Day
3.82651
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-07-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-05-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-10-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
31.33300
Number of Facility Reported Incidents
1
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
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