Fairview Developmental Center - Costa Mesa Nursing Home
General Information
UPDATEFederal Provider Number
05A311
Provider Name
FAIRVIEW DEVELOPMENTAL CENTER
Provider Address
2501 HARBOR BOULEVARD
COSTA MESA, CA 92626
COSTA MESA, CA 92626
Provider Phone Number
7149575000
Provider SSA County
400
Provider County Name
Orange
Ownership Type
Government - State
Number of Certified Beds
396
Number of Residents in Certified Beds
122
Provider Type
Medicaid
Provider Resides in Hospital
Y
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1978-02-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
0.61352
Reported LPN Staffing Hours per Resident per Day
0.43607
Reported RN Staffing Hours per Resident per Day
2.87254
Reported Licensed Staffing Hours per Resident per Day
3.30861
Reported Total Nurse Staffing Hours per Resident per Day
3.92213
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04672
Expected CNA Staffing Hours per Resident per Day
2.68575
Expected LPN Staffing Hours per Resident per Day
0.88363
Expected RN Staffing Hours per Resident per Day
1.22588
Expected Total Nurse Staffing Hours per Resident per Day
4.79526
Adjusted CNA Staffing Hours per Resident per Day
0.56051
Adjusted LPN Staffing Hours per Resident per Day
0.40960
Adjusted RN Staffing Hours per Resident per Day
1.75088
Adjusted Total Nurse Staffing Hours per Resident per Day
3.29695
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2014-10-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
80
Cycle 2 Standard Health Survey Date
2013-11-15
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
12
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2012-12-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
72.66700
Number of Facility Reported Incidents
10
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
Nursiong Homes Nearby
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COSTA MESA CA 92627 | 1.5 miles away
Newport Subacute Healthcare Center
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COSTA MESA CA 92627 | 1.6 miles away
Newport Nursing And Rehabilitation Center
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Flagship Healthcare Center
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Country Villa Plaza Convalescent Center
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South Coast Global Medical Center, Inc D/p Snf
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Beachside Nursing Center
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Sea Cliff Healthcare Center
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Huntington Valley Healthcare Center
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South Coast Post Acute
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Regents Point - Windcrest
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St Edna Subacute And Rehabilitation Center
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