Forest Hill Manor Health Center - Pacific Grove Nursing Home
General Information
UPDATEFederal Provider Number
555867
Provider Name
FOREST HILL MANOR HEALTH CENTER
Provider Address
551 GIBSON AVENUE
PACIFIC GROVE, CA 93950
PACIFIC GROVE, CA 93950
Provider Phone Number
(831) 657-5200
Provider SSA County
370
Provider County Name
Monterey
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
26
Number of Residents in Certified Beds
15
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
CALIFORNIA-NEVADA METHODIST HOMES
Date First Approved to Provide Medicare and Medicaid services
2010-09-23
Continuing Care Retirement Community
Y
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
4
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
3.15000
Reported LPN Staffing Hours per Resident per Day
1.64000
Reported RN Staffing Hours per Resident per Day
0.89000
Reported Licensed Staffing Hours per Resident per Day
2.53000
Reported Total Nurse Staffing Hours per Resident per Day
5.68000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11000
Expected CNA Staffing Hours per Resident per Day
2.41163
Expected LPN Staffing Hours per Resident per Day
0.56335
Expected RN Staffing Hours per Resident per Day
0.91120
Expected Total Nurse Staffing Hours per Resident per Day
3.88617
Adjusted CNA Staffing Hours per Resident per Day
3.20495
Adjusted LPN Staffing Hours per Resident per Day
2.41626
Adjusted RN Staffing Hours per Resident per Day
0.72982
Adjusted Total Nurse Staffing Hours per Resident per Day
5.89153
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2015-03-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2014-02-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2013-05-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
32.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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