Comm. Hosp. Of San Bernardino Dp Snf - San Bernardino Nursing Home
General Information
UPDATEFederal Provider Number
555522
Provider Name
COMM. HOSP. OF SAN BERNARDINO DP SNF
Provider Address
1805 MEDICAL CTR DR.
SAN BERNARDINO, CA 92411
SAN BERNARDINO, CA 92411
Provider Phone Number
(909) 887-6333
Provider SSA County
460
Provider County Name
San Bernardino
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
88
Number of Residents in Certified Beds
86
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
COMMUNITY HOSPITAL OF SAN BERNARDINO
Date First Approved to Provide Medicare and Medicaid services
1992-09-08
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.39535
Reported LPN Staffing Hours per Resident per Day
4.25523
Reported RN Staffing Hours per Resident per Day
1.50116
Reported Licensed Staffing Hours per Resident per Day
5.75640
Reported Total Nurse Staffing Hours per Resident per Day
9.15174
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01221
Expected CNA Staffing Hours per Resident per Day
2.78531
Expected LPN Staffing Hours per Resident per Day
1.46042
Expected RN Staffing Hours per Resident per Day
1.88532
Expected Total Nurse Staffing Hours per Resident per Day
6.13105
Adjusted CNA Staffing Hours per Resident per Day
2.99111
Adjusted LPN Staffing Hours per Resident per Day
2.41837
Adjusted RN Staffing Hours per Resident per Day
0.59495
Adjusted Total Nurse Staffing Hours per Resident per Day
6.01687
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2015-01-26
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
14
Cycle 2 Number of Standard Health Deficiencies
14
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
263
Cycle 2 Standard Health Survey Date
2014-02-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
263
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2013-03-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
111.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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