Canterbury Woods - Pacific Grove Nursing Home
General Information
UPDATEFederal Provider Number
55303
Provider Name
CANTERBURY WOODS
Provider Address
651 SINEX AVENUE
PACIFIC GROVE, CA 93950
PACIFIC GROVE, CA 93950
Provider Phone Number
(831) 373-3111
Provider SSA County
370
Provider County Name
Monterey
Provider Website
Provider Description
Ownership Type
Non profit - Other
Number of Certified Beds
24
Number of Residents in Certified Beds
20
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
EPISCOPAL SENIOR COMMUNITIES
Date First Approved to Provide Medicare and Medicaid services
1972-11-09
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
3
Health Inspection Rating Footnote
QM Rating
5
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
4.60750
Reported LPN Staffing Hours per Resident per Day
0.45750
Reported RN Staffing Hours per Resident per Day
1.64500
Reported Licensed Staffing Hours per Resident per Day
2.10250
Reported Total Nurse Staffing Hours per Resident per Day
6.71000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11500
Expected CNA Staffing Hours per Resident per Day
2.49629
Expected LPN Staffing Hours per Resident per Day
0.52806
Expected RN Staffing Hours per Resident per Day
0.75948
Expected Total Nurse Staffing Hours per Resident per Day
3.78383
Adjusted CNA Staffing Hours per Resident per Day
4.52889
Adjusted LPN Staffing Hours per Resident per Day
0.71909
Adjusted RN Staffing Hours per Resident per Day
1.61841
Adjusted Total Nurse Staffing Hours per Resident per Day
7.14814
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-05-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
72
Cycle 2 Standard Health Survey Date
2013-04-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
72
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-05-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
49.33300
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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