Children's Recovery Center Of No Ca D/p Snf - Campbell Nursing Home

General Information

UPDATE
Federal Provider Number
555734
Provider Name
CHILDREN'S RECOVERY CENTER OF NO CA D/P SNF
Provider Address
3777 SOUTH BASCOM AVENUE
CAMPBELL, CA 95008
Provider Phone Number
4085583640
Provider SSA County
530
Provider County Name
Santa Clara
Ownership Type
For profit - Corporation
Number of Certified Beds
27
Number of Residents in Certified Beds
21
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1999-03-03
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
5
Overall Rating Footnote
Health Inspection Rating
4
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
3.16429
Reported LPN Staffing Hours per Resident per Day
3.29762
Reported RN Staffing Hours per Resident per Day
3.57143
Reported Licensed Staffing Hours per Resident per Day
6.86905
Reported Total Nurse Staffing Hours per Resident per Day
10.03334
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11905
Expected CNA Staffing Hours per Resident per Day
2.89120
Expected LPN Staffing Hours per Resident per Day
1.42295
Expected RN Staffing Hours per Resident per Day
2.18133
Expected Total Nurse Staffing Hours per Resident per Day
6.49547
Adjusted CNA Staffing Hours per Resident per Day
2.68547
Adjusted LPN Staffing Hours per Resident per Day
1.92349
Adjusted RN Staffing Hours per Resident per Day
1.22337
Adjusted Total Nurse Staffing Hours per Resident per Day
6.22640
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-05-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-04-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-05-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
29.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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