Foothill Regional Medical Center D/p Snf - Tustin Nursing Home
General Information
UPDATEFederal Provider Number
555730
Provider Name
FOOTHILL REGIONAL MEDICAL CENTER D/P SNF
Provider Address
14662 NEWPORT AVENUE
TUSTIN, CA 92780
TUSTIN, CA 92780
Provider Phone Number
(714) 619-7700
Provider SSA County
400
Provider County Name
Orange
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
42
Number of Residents in Certified Beds
21
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ALTA NEWPORT HOSPITAL INC
Date First Approved to Provide Medicare and Medicaid services
1998-09-25
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
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
0
Staffing Rating Footnote
Data Not Available
RN Staffing Rating
0
RN Staffing Rating Footnote
Data Not Available
Reported Staffing Footnote
Staffing Values not Reported because of Data Quality Concerns
Physical Therapist Staffing Footnote
Physical Therapy Staffing Values not Reported because of Data Quality Concerns
Reported CNA Staffing Hours per Resident per Day
0.00000
Reported LPN Staffing Hours per Resident per Day
0.00000
Reported RN Staffing Hours per Resident per Day
0.00000
Reported Licensed Staffing Hours per Resident per Day
0.00000
Reported Total Nurse Staffing Hours per Resident per Day
0.00000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.75065
Expected LPN Staffing Hours per Resident per Day
1.44712
Expected RN Staffing Hours per Resident per Day
1.83785
Expected Total Nurse Staffing Hours per Resident per Day
6.03562
Adjusted CNA Staffing Hours per Resident per Day
0.00000
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
0.00000
Adjusted Total Nurse Staffing Hours per Resident per Day
0.00000
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2014-09-30
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
15
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
104
Cycle 2 Standard Health Survey Date
2013-08-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
104
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-09-24
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
70.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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