Lake Park Retirement Residence - Oakland Nursing Home
General Information
UPDATEFederal Provider Number
555113
Provider Name
LAKE PARK RETIREMENT RESIDENCE
Provider Address
1850 ALICE STREET
OAKLAND, CA 94612
OAKLAND, CA 94612
Provider Phone Number
(510) 835-5511
Provider SSA County
0
Provider County Name
Alameda
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
35
Number of Residents in Certified Beds
27
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
CALIFORNIA-NEVADA METHODIST HOMES
Date First Approved to Provide Medicare and Medicaid services
1979-07-01
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
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.59259
Reported LPN Staffing Hours per Resident per Day
0.52407
Reported RN Staffing Hours per Resident per Day
0.65556
Reported Licensed Staffing Hours per Resident per Day
1.17963
Reported Total Nurse Staffing Hours per Resident per Day
3.77222
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10556
Expected CNA Staffing Hours per Resident per Day
2.31715
Expected LPN Staffing Hours per Resident per Day
0.50826
Expected RN Staffing Hours per Resident per Day
0.81811
Expected Total Nurse Staffing Hours per Resident per Day
3.64351
Adjusted CNA Staffing Hours per Resident per Day
2.74537
Adjusted LPN Staffing Hours per Resident per Day
0.85582
Adjusted RN Staffing Hours per Resident per Day
0.59874
Adjusted Total Nurse Staffing Hours per Resident per Day
4.17329
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2014-05-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
80
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-03-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-08-02
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
48.00000
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
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