Brookdale San Juan Capistrano - San Juan Capistrano Nursing Home
General Information
UPDATEFederal Provider Number
555763
Provider Name
BROOKDALE SAN JUAN CAPISTRANO
Provider Address
31741 RANCHO VIEJO ROAD
SAN JUAN CAPISTRANO, CA 92675
SAN JUAN CAPISTRANO, CA 92675
Provider Phone Number
(949) 248-8855
Provider SSA County
400
Provider County Name
Orange
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
45
Number of Residents in Certified Beds
39
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
2000-08-31
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
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
1.93205
Reported LPN Staffing Hours per Resident per Day
0.62179
Reported RN Staffing Hours per Resident per Day
1.15385
Reported Licensed Staffing Hours per Resident per Day
1.77564
Reported Total Nurse Staffing Hours per Resident per Day
3.70769
Reported Physical Therapist Staffing Hours per Resident Per Day
0.30769
Expected CNA Staffing Hours per Resident per Day
2.39853
Expected LPN Staffing Hours per Resident per Day
0.82156
Expected RN Staffing Hours per Resident per Day
1.70714
Expected Total Nurse Staffing Hours per Resident per Day
4.92723
Adjusted CNA Staffing Hours per Resident per Day
1.97649
Adjusted LPN Staffing Hours per Resident per Day
0.62818
Adjusted RN Staffing Hours per Resident per Day
0.50503
Adjusted Total Nurse Staffing Hours per Resident per Day
3.03321
Cycle 1 Total Number of Health Deficiencies
23
Cycle 1 Number of Standard Health Deficiencies
16
Cycle 1 Number of Complaint Health Deficiencies
7
Cycle 1 Health Deficiency Score
100
Cycle 1 Standard Survey Health Date
2014-10-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
100
Cycle 2 Total Number of Health Deficiencies
17
Cycle 2 Number of Standard Health Deficiencies
17
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
112
Cycle 2 Standard Health Survey Date
2013-11-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
112
Cycle 3 Total Number of Health Deficiencies
24
Cycle 3 Number of Standard Health Deficiencies
15
Cycle 3 Number of Complaint Health Deficiencies
9
Cycle 3 Health Deficiency Score
136
Cycle 3 Standard Health Survey Date
2013-01-03
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
136
Total Weighted Health Survey Score
110.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
11
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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