California Pacific Medical Ctr- Davies Campus Hosp - San Francisco Nursing Home
General Information
UPDATEFederal Provider Number
56245
Provider Name
CALIFORNIA PACIFIC MEDICAL CTR- DAVIES CAMPUS HOSP
Provider Address
601 DUBOCE AVE
SAN FRANCISCO, CA 94117
SAN FRANCISCO, CA 94117
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
38
Number of Residents in Certified Beds
31
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
1970-10-19
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
2.09677
Reported LPN Staffing Hours per Resident per Day
0.07419
Reported RN Staffing Hours per Resident per Day
2.81129
Reported Licensed Staffing Hours per Resident per Day
2.88548
Reported Total Nurse Staffing Hours per Resident per Day
4.98225
Reported Physical Therapist Staffing Hours per Resident Per Day
0.27581
Expected CNA Staffing Hours per Resident per Day
2.64647
Expected LPN Staffing Hours per Resident per Day
1.11093
Expected RN Staffing Hours per Resident per Day
1.90658
Expected Total Nurse Staffing Hours per Resident per Day
5.66397
Adjusted CNA Staffing Hours per Resident per Day
1.94404
Adjusted LPN Staffing Hours per Resident per Day
0.05543
Adjusted RN Staffing Hours per Resident per Day
1.10176
Adjusted Total Nurse Staffing Hours per Resident per Day
3.54574
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-07-31
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
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
28
Cycle 2 Standard Health Survey Date
2013-07-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-08-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
38.66700
Number of Facility Reported Incidents
0
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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