Golden Living Center - Hy-pana - Stockton Nursing Home
General Information
UPDATEFederal Provider Number
55201
Provider Name
GOLDEN LIVING CENTER - HY-PANA
Provider Address
4545 SHELLEY COURT
STOCKTON, CA 95207
STOCKTON, CA 95207
Provider Phone Number
(209) 477-0271
Provider SSA County
490
Provider County Name
San Joaquin
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
119
Number of Residents in Certified Beds
110
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GGNSC STOCKTON LP
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
2.25455
Reported LPN Staffing Hours per Resident per Day
0.71500
Reported RN Staffing Hours per Resident per Day
0.55182
Reported Licensed Staffing Hours per Resident per Day
1.26682
Reported Total Nurse Staffing Hours per Resident per Day
3.52137
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03227
Expected CNA Staffing Hours per Resident per Day
2.52686
Expected LPN Staffing Hours per Resident per Day
0.64524
Expected RN Staffing Hours per Resident per Day
1.01181
Expected Total Nurse Staffing Hours per Resident per Day
4.18391
Adjusted CNA Staffing Hours per Resident per Day
2.18928
Adjusted LPN Staffing Hours per Resident per Day
0.91973
Adjusted RN Staffing Hours per Resident per Day
0.40751
Adjusted Total Nurse Staffing Hours per Resident per Day
3.39259
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2015-03-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
9
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2014-03-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
64
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2013-03-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
41.33300
Number of Facility Reported Incidents
9
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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