Elmwood Care Center - Berkeley Nursing Home
General Information
UPDATEFederal Provider Number
555819
Provider Name
ELMWOOD CARE CENTER
Provider Address
2829 SHATTUCK AVENUE
BERKELEY, CA 94705
BERKELEY, CA 94705
Provider Phone Number
5106652800
Provider SSA County
0
Provider County Name
Alameda
Ownership Type
For profit - Corporation
Number of Certified Beds
74
Number of Residents in Certified Beds
73
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SHATTUCK HEALTHCARE INC
Date First Approved to Provide Medicare and Medicaid services
2005-04-19
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
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
2.39863
Reported LPN Staffing Hours per Resident per Day
0.59041
Reported RN Staffing Hours per Resident per Day
1.00479
Reported Licensed Staffing Hours per Resident per Day
1.59521
Reported Total Nurse Staffing Hours per Resident per Day
3.99383
Reported Physical Therapist Staffing Hours per Resident Per Day
0.17123
Expected CNA Staffing Hours per Resident per Day
2.44091
Expected LPN Staffing Hours per Resident per Day
0.77919
Expected RN Staffing Hours per Resident per Day
1.37764
Expected Total Nurse Staffing Hours per Resident per Day
4.59774
Adjusted CNA Staffing Hours per Resident per Day
2.41120
Adjusted LPN Staffing Hours per Resident per Day
0.62891
Adjusted RN Staffing Hours per Resident per Day
0.54498
Adjusted Total Nurse Staffing Hours per Resident per Day
3.50145
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-08-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-05-02
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
20
Cycle 3 Number of Standard Health Deficiencies
15
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
96
Cycle 3 Standard Health Survey Date
2012-02-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
96
Total Weighted Health Survey Score
43.33300
Number of Facility Reported Incidents
6
Number of Substantiated Complaints
7
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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