Brookdale Carmel Valley - San Diego Nursing Home
General Information
UPDATEFederal Provider Number
555746
Provider Name
BROOKDALE CARMEL VALLEY
Provider Address
13101 HARTFIELD AVE
SAN DIEGO, CA 92130
SAN DIEGO, CA 92130
Provider Phone Number
(858) 259-2222
Provider SSA County
470
Provider County Name
San Diego
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
45
Number of Residents in Certified Beds
43
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1999-10-14
Continuing Care Retirement Community
Y
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
4
Health Inspection Rating Footnote
QM Rating
5
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
2.21047
Reported LPN Staffing Hours per Resident per Day
0.88605
Reported RN Staffing Hours per Resident per Day
0.91163
Reported Licensed Staffing Hours per Resident per Day
1.79767
Reported Total Nurse Staffing Hours per Resident per Day
4.00815
Reported Physical Therapist Staffing Hours per Resident Per Day
0.41860
Expected CNA Staffing Hours per Resident per Day
2.51782
Expected LPN Staffing Hours per Resident per Day
0.71259
Expected RN Staffing Hours per Resident per Day
1.34064
Expected Total Nurse Staffing Hours per Resident per Day
4.57105
Adjusted CNA Staffing Hours per Resident per Day
2.15418
Adjusted LPN Staffing Hours per Resident per Day
1.03205
Adjusted RN Staffing Hours per Resident per Day
0.50809
Adjusted Total Nurse Staffing Hours per Resident per Day
3.53452
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-05-28
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-06-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-07-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
34.00000
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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