Country Care Convalescent Hospital - Atascadero Nursing Home
General Information
UPDATEFederal Provider Number
555618
Provider Name
COUNTRY CARE CONVALESCENT HOSPITAL
Provider Address
14900 EL CAMINO REAL
ATASCADERO, CA 93422
ATASCADERO, CA 93422
Provider Phone Number
(805) 466-0282
Provider SSA County
500
Provider County Name
San Luis Obispo
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
57
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ATASCADERO CHRISTIAN HOME
Date First Approved to Provide Medicare and Medicaid services
1994-05-03
Continuing Care Retirement Community
N
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.45175
Reported LPN Staffing Hours per Resident per Day
0.62193
Reported RN Staffing Hours per Resident per Day
0.45000
Reported Licensed Staffing Hours per Resident per Day
1.07193
Reported Total Nurse Staffing Hours per Resident per Day
3.52368
Reported Physical Therapist Staffing Hours per Resident Per Day
0.18684
Expected CNA Staffing Hours per Resident per Day
2.33343
Expected LPN Staffing Hours per Resident per Day
0.59041
Expected RN Staffing Hours per Resident per Day
1.10342
Expected Total Nurse Staffing Hours per Resident per Day
4.02726
Adjusted CNA Staffing Hours per Resident per Day
2.57812
Adjusted LPN Staffing Hours per Resident per Day
0.87430
Adjusted RN Staffing Hours per Resident per Day
0.30473
Adjusted Total Nurse Staffing Hours per Resident per Day
3.52686
Cycle 1 Total Number of Health Deficiencies
25
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
13
Cycle 1 Health Deficiency Score
120
Cycle 1 Standard Survey Health Date
2014-03-18
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
120
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-03-08
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-04-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
72.00000
Number of Facility Reported Incidents
13
Number of Substantiated Complaints
2
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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