California Pacific Medical Ctr - Calif East Campus - San Francisco Nursing Home
General Information
UPDATEFederal Provider Number
555197
Provider Name
CALIFORNIA PACIFIC MEDICAL CTR - CALIF EAST CAMPUS
Provider Address
3698 CALIFORNIA STREET
SAN FRANCISCO, CA 94118
SAN FRANCISCO, CA 94118
Provider Phone Number
(415) 600-6000
Provider SSA County
480
Provider County Name
San Francisco
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
48
Number of Residents in Certified Beds
13
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
SUTTER WEST BAY HOSPITALS
Date First Approved to Provide Medicare and Medicaid services
1985-03-20
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
1
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
4.28462
Reported LPN Staffing Hours per Resident per Day
0.04231
Reported RN Staffing Hours per Resident per Day
5.12692
Reported Licensed Staffing Hours per Resident per Day
5.16923
Reported Total Nurse Staffing Hours per Resident per Day
9.45385
Reported Physical Therapist Staffing Hours per Resident Per Day
0.80769
Expected CNA Staffing Hours per Resident per Day
2.51203
Expected LPN Staffing Hours per Resident per Day
1.08768
Expected RN Staffing Hours per Resident per Day
2.18639
Expected Total Nurse Staffing Hours per Resident per Day
5.78609
Adjusted CNA Staffing Hours per Resident per Day
4.18513
Adjusted LPN Staffing Hours per Resident per Day
0.03229
Adjusted RN Staffing Hours per Resident per Day
1.75213
Adjusted Total Nurse Staffing Hours per Resident per Day
6.58605
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-09-04
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
12
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
80
Cycle 2 Standard Health Survey Date
2013-09-24
Cycle 2 Number of Health Revisits
3
Cycle 2 Health Revisit Score
56
Cycle 2 Total Health Score
136
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
52
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
52
Total Weighted Health Survey Score
76.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
1
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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