Freedom Village Healthcare Center - Lake Forest Nursing Home
General Information
UPDATEFederal Provider Number
555391
Provider Name
FREEDOM VILLAGE HEALTHCARE CENTER
Provider Address
23442 EL TORO ROAD
LAKE FOREST, CA 92630
LAKE FOREST, CA 92630
Provider Phone Number
9494720277
Provider SSA County
400
Provider County Name
Orange
Ownership Type
For profit - Partnership
Number of Certified Beds
52
Number of Residents in Certified Beds
44
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CASA PACIFICA
Date First Approved to Provide Medicare and Medicaid services
1989-10-26
Continuing Care Retirement Community
Y
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
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.82500
Reported LPN Staffing Hours per Resident per Day
0.83295
Reported RN Staffing Hours per Resident per Day
0.99773
Reported Licensed Staffing Hours per Resident per Day
1.83068
Reported Total Nurse Staffing Hours per Resident per Day
4.65568
Reported Physical Therapist Staffing Hours per Resident Per Day
0.17045
Expected CNA Staffing Hours per Resident per Day
2.73162
Expected LPN Staffing Hours per Resident per Day
0.64532
Expected RN Staffing Hours per Resident per Day
1.14319
Expected Total Nurse Staffing Hours per Resident per Day
4.52013
Adjusted CNA Staffing Hours per Resident per Day
2.53758
Adjusted LPN Staffing Hours per Resident per Day
1.07132
Adjusted RN Staffing Hours per Resident per Day
0.65213
Adjusted Total Nurse Staffing Hours per Resident per Day
4.15178
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2015-01-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
76
Cycle 2 Standard Health Survey Date
2014-01-09
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
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2013-01-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
55.33300
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
Nursiong Homes Nearby
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Lake Forest Nursing Center
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Palm Terrace Healthcare & Rehabilitation Center
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Foothill Regional Medical Center D/p Snf
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Tustin Care Center
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Advanced Rehab Center Of Tustin
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Newport Subacute 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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South Coast Post Acute
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