Golden Age Convalescent Hospital - Capitola Nursing Home
General Information
UPDATEFederal Provider Number
05A103
Provider Name
GOLDEN AGE CONVALESCENT HOSPITAL
Provider Address
523 BURLINGAME AVENUE
CAPITOLA, CA 95010
CAPITOLA, CA 95010
Provider Phone Number
8314750722
Provider SSA County
540
Provider County Name
Santa Cruz
Ownership Type
For profit - Corporation
Number of Certified Beds
40
Number of Residents in Certified Beds
25
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1974-03-31
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
4
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.56000
Reported LPN Staffing Hours per Resident per Day
0.73200
Reported RN Staffing Hours per Resident per Day
0.51400
Reported Licensed Staffing Hours per Resident per Day
1.24600
Reported Total Nurse Staffing Hours per Resident per Day
3.80600
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
1.98714
Expected LPN Staffing Hours per Resident per Day
0.53927
Expected RN Staffing Hours per Resident per Day
0.75123
Expected Total Nurse Staffing Hours per Resident per Day
3.27764
Adjusted CNA Staffing Hours per Resident per Day
3.16106
Adjusted LPN Staffing Hours per Resident per Day
1.12663
Adjusted RN Staffing Hours per Resident per Day
0.51124
Adjusted Total Nurse Staffing Hours per Resident per Day
4.68068
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
15
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-11-21
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
17
Cycle 2 Number of Standard Health Deficiencies
17
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
84
Cycle 2 Standard Health Survey Date
2013-11-04
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
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-10-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
68.66700
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
Nursiong Homes Nearby
Pacific Coast Manor
1935 Wharf Road |
CAPITOLA CA 95010 | 0.3 mile away
Driftwood Healthcare Center - Santa Cruz
675 24th Avenue |
SANTA CRUZ CA 95062 | 1.7 miles away
Hearts & Hands, Post Acute Care & Rehab Center
2990 Soquel Avenue |
SANTA CRUZ CA 95062 | 1.9 miles away
Kindred Nursing And Transitional Care-santa Cruz
1115 Capitola Road |
SANTA CRUZ CA 95062 | 1.9 miles away
Cresthaven Skilled Nursing Facility, Inc
740 17th Avenue |
SANTA CRUZ CA 95062 | 1.9 miles away
Watsonville Post Acute Center
525 Auto Center Drive |
WATSONVILLE CA 95076 | 11 miles away
Watsonville Nursing Center
535 Auto Center Drive |
WATSONVILLE CA 95076 | 11 miles away
Valley Convalescent Hospital
919 Freedom Blvd |
WATSONVILLE CA 95076 | 11.3 miles away
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