Fallbrook Hospital District Skilled Nursing Facili - Fallbrook Nursing Home
General Information
UPDATEFederal Provider Number
55298
Provider Name
FALLBROOK HOSPITAL DISTRICT SKILLED NURSING FACILI
Provider Address
325 POTTER AVENUE
FALLBROOK, CA 92028
FALLBROOK, CA 92028
Provider Phone Number
7607282330
Provider SSA County
470
Provider County Name
San Diego
Ownership Type
For profit - Corporation
Number of Certified Beds
93
Number of Residents in Certified Beds
61
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
FALLBROOK HOSPITAL DISTRICT
Date First Approved to Provide Medicare and Medicaid services
1977-07-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
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
2.84836
Reported LPN Staffing Hours per Resident per Day
1.07705
Reported RN Staffing Hours per Resident per Day
1.16148
Reported Licensed Staffing Hours per Resident per Day
2.23852
Reported Total Nurse Staffing Hours per Resident per Day
5.08689
Reported Physical Therapist Staffing Hours per Resident Per Day
0.15246
Expected CNA Staffing Hours per Resident per Day
2.53057
Expected LPN Staffing Hours per Resident per Day
0.58416
Expected RN Staffing Hours per Resident per Day
0.99594
Expected Total Nurse Staffing Hours per Resident per Day
4.11067
Adjusted CNA Staffing Hours per Resident per Day
2.76183
Adjusted LPN Staffing Hours per Resident per Day
1.53032
Adjusted RN Staffing Hours per Resident per Day
0.87140
Adjusted Total Nurse Staffing Hours per Resident per Day
4.98817
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-08-21
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-08-21
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-10-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
8.00000
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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