Golden Living Center - Portside - Stockton Nursing Home
General Information
UPDATEFederal Provider Number
555105
Provider Name
GOLDEN LIVING CENTER - PORTSIDE
Provider Address
2740 NORTH CALIFORNIA STREET
STOCKTON, CA 95204
STOCKTON, CA 95204
Provider Phone Number
(209) 466-3522
Provider SSA County
490
Provider County Name
San Joaquin
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
94
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BEVERLY HEALTH AND REHABILITATION SERVICES, INC
Date First Approved to Provide Medicare and Medicaid services
1978-12-29
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
2.38351
Reported LPN Staffing Hours per Resident per Day
0.58670
Reported RN Staffing Hours per Resident per Day
1.69362
Reported Licensed Staffing Hours per Resident per Day
2.28032
Reported Total Nurse Staffing Hours per Resident per Day
4.66383
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01596
Expected CNA Staffing Hours per Resident per Day
2.41677
Expected LPN Staffing Hours per Resident per Day
0.59264
Expected RN Staffing Hours per Resident per Day
0.93901
Expected Total Nurse Staffing Hours per Resident per Day
3.94842
Adjusted CNA Staffing Hours per Resident per Day
2.41993
Adjusted LPN Staffing Hours per Resident per Day
0.82168
Adjusted RN Staffing Hours per Resident per Day
1.34767
Adjusted Total Nurse Staffing Hours per Resident per Day
4.76126
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2015-03-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2014-03-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2013-03-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
33.33300
Number of Facility Reported Incidents
4
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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