Garden Grove Convalescent Hosp - Garden Grove Nursing Home
General Information
UPDATEFederal Provider Number
56145
Provider Name
GARDEN GROVE CONVALESCENT HOSP
Provider Address
12882 SHACKELFORD LANE
GARDEN GROVE, CA 92841
GARDEN GROVE, CA 92841
Provider Phone Number
(714) 638-9470
Provider SSA County
400
Provider County Name
Orange
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
98
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GARDEN GROVE CONVALESCENT HOSPITAL INC
Date First Approved to Provide Medicare and Medicaid services
1971-01-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.35204
Reported LPN Staffing Hours per Resident per Day
0.85918
Reported RN Staffing Hours per Resident per Day
0.44235
Reported Licensed Staffing Hours per Resident per Day
1.30153
Reported Total Nurse Staffing Hours per Resident per Day
3.65357
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05816
Expected CNA Staffing Hours per Resident per Day
2.55398
Expected LPN Staffing Hours per Resident per Day
0.60458
Expected RN Staffing Hours per Resident per Day
0.91276
Expected Total Nurse Staffing Hours per Resident per Day
4.07133
Adjusted CNA Staffing Hours per Resident per Day
2.25969
Adjusted LPN Staffing Hours per Resident per Day
1.17952
Adjusted RN Staffing Hours per Resident per Day
0.36212
Adjusted Total Nurse Staffing Hours per Resident per Day
3.61729
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
104
Cycle 1 Standard Survey Health Date
2014-05-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
104
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-04-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-05-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
64.66700
Number of Facility Reported Incidents
0
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
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