Gordon Lane Care Center - Fullerton Nursing Home
General Information
UPDATEFederal Provider Number
555797
Provider Name
GORDON LANE CARE CENTER
Provider Address
1821 E CHAPMAN AVE
FULLERTON, CA 92831
FULLERTON, CA 92831
Provider Phone Number
7148797301
Provider SSA County
400
Provider County Name
Orange
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
GORDON LANE HEALTHCARE LLC
Date First Approved to Provide Medicare and Medicaid services
2002-10-18
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
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
2.28723
Reported LPN Staffing Hours per Resident per Day
0.63936
Reported RN Staffing Hours per Resident per Day
0.66436
Reported Licensed Staffing Hours per Resident per Day
1.30372
Reported Total Nurse Staffing Hours per Resident per Day
3.59095
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11915
Expected CNA Staffing Hours per Resident per Day
2.51438
Expected LPN Staffing Hours per Resident per Day
0.72169
Expected RN Staffing Hours per Resident per Day
1.17714
Expected Total Nurse Staffing Hours per Resident per Day
4.41320
Adjusted CNA Staffing Hours per Resident per Day
2.23203
Adjusted LPN Staffing Hours per Resident per Day
0.73532
Adjusted RN Staffing Hours per Resident per Day
0.42171
Adjusted Total Nurse Staffing Hours per Resident per Day
3.27988
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
88
Cycle 1 Standard Survey Health Date
2014-04-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
88
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
72
Cycle 2 Standard Health Survey Date
2013-04-04
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
26
Cycle 3 Number of Standard Health Deficiencies
23
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
120
Cycle 3 Standard Health Survey Date
2012-04-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
120
Total Weighted Health Survey Score
88.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
4
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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