Golden Livingcenter - San Jose - San Jose Nursing Home
General Information
UPDATEFederal Provider Number
05A277
Provider Name
GOLDEN LIVINGCENTER - SAN JOSE
Provider Address
401 RIDGE VISTA AVENUE
SAN JOSE, CA 95127
SAN JOSE, CA 95127
Provider Phone Number
(408) 923-7232
Provider SSA County
530
Provider County Name
Santa Clara
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
116
Number of Residents in Certified Beds
110
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
1976-04-08
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
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
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
0.00000
Reported LPN Staffing Hours per Resident per Day
1.84227
Reported RN Staffing Hours per Resident per Day
0.70500
Reported Licensed Staffing Hours per Resident per Day
2.54727
Reported Total Nurse Staffing Hours per Resident per Day
2.54727
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
1.40373
Expected LPN Staffing Hours per Resident per Day
0.46556
Expected RN Staffing Hours per Resident per Day
0.62764
Expected Total Nurse Staffing Hours per Resident per Day
2.49693
Adjusted CNA Staffing Hours per Resident per Day
0.00000
Adjusted LPN Staffing Hours per Resident per Day
3.28439
Adjusted RN Staffing Hours per Resident per Day
0.83930
Adjusted Total Nurse Staffing Hours per Resident per Day
4.11216
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-10-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2013-11-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
56
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-12-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
45.33300
Number of Facility Reported Incidents
8
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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