Courtyard Care Center - San Jose Nursing Home
General Information
UPDATEFederal Provider Number
555635
Provider Name
COURTYARD CARE CENTER
Provider Address
340 NORTHLAKE DRIVE
SAN JOSE, CA 95117
SAN JOSE, CA 95117
Provider Phone Number
(408) 249-0344
Provider SSA County
530
Provider County Name
Santa Clara
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
76
Number of Residents in Certified Beds
70
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SSC SAN JOSE OPERATING COMPANY LP
Date First Approved to Provide Medicare and Medicaid services
1995-05-24
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
2.23071
Reported LPN Staffing Hours per Resident per Day
0.46429
Reported RN Staffing Hours per Resident per Day
0.84500
Reported Licensed Staffing Hours per Resident per Day
1.30929
Reported Total Nurse Staffing Hours per Resident per Day
3.54000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07357
Expected CNA Staffing Hours per Resident per Day
2.51497
Expected LPN Staffing Hours per Resident per Day
0.67594
Expected RN Staffing Hours per Resident per Day
1.10170
Expected Total Nurse Staffing Hours per Resident per Day
4.29260
Adjusted CNA Staffing Hours per Resident per Day
2.17637
Adjusted LPN Staffing Hours per Resident per Day
0.57011
Adjusted RN Staffing Hours per Resident per Day
0.57310
Adjusted Total Nurse Staffing Hours per Resident per Day
3.32418
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-10-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
84
Cycle 2 Standard Health Survey Date
2014-01-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
84
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2013-03-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
50.66700
Number of Facility Reported Incidents
4
Number of Substantiated Complaints
4
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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