Empress Care Center, Llc - San Jose Nursing Home
General Information
UPDATEFederal Provider Number
56026
Provider Name
EMPRESS CARE CENTER, LLC
Provider Address
1299 S. BASCOM AVENUE
SAN JOSE, CA 95128
SAN JOSE, CA 95128
Provider Phone Number
(408) 287-0616
Provider SSA County
530
Provider County Name
Santa Clara
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
67
Number of Residents in Certified Beds
62
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EMPRESS CARE CENTER, LLC
Date First Approved to Provide Medicare and Medicaid services
1969-02-10
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.96774
Reported LPN Staffing Hours per Resident per Day
0.70968
Reported RN Staffing Hours per Resident per Day
0.21935
Reported Licensed Staffing Hours per Resident per Day
0.92903
Reported Total Nurse Staffing Hours per Resident per Day
3.89677
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06935
Expected CNA Staffing Hours per Resident per Day
2.12797
Expected LPN Staffing Hours per Resident per Day
0.64722
Expected RN Staffing Hours per Resident per Day
1.03375
Expected Total Nurse Staffing Hours per Resident per Day
3.80894
Adjusted CNA Staffing Hours per Resident per Day
3.42202
Adjusted LPN Staffing Hours per Resident per Day
0.91010
Adjusted RN Staffing Hours per Resident per Day
0.15855
Adjusted Total Nurse Staffing Hours per Resident per Day
4.12385
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-10-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-11-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2013-02-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
14.66700
Number of Facility Reported Incidents
3
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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