Legacy Post-acute Rehabilitation - San Bernardino Nursing Home
General Information
UPDATEFederal Provider Number
55708
Provider Name
LEGACY POST-ACUTE REHABILITATION
Provider Address
1335 N. WATERMAN AVENUE
SAN BERNARDINO, CA 92404
SAN BERNARDINO, CA 92404
Provider Phone Number
(909) 885-0268
Provider SSA County
460
Provider County Name
San Bernardino
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
119
Number of Residents in Certified Beds
105
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
SAN BERNARDINO CONVALESCENT OPERATIONS, INC.
Date First Approved to Provide Medicare and Medicaid services
1971-01-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
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
2.74286
Reported LPN Staffing Hours per Resident per Day
2.28571
Reported RN Staffing Hours per Resident per Day
0.99667
Reported Licensed Staffing Hours per Resident per Day
3.28238
Reported Total Nurse Staffing Hours per Resident per Day
6.02524
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10905
Expected CNA Staffing Hours per Resident per Day
2.74731
Expected LPN Staffing Hours per Resident per Day
1.20698
Expected RN Staffing Hours per Resident per Day
1.75085
Expected Total Nurse Staffing Hours per Resident per Day
5.70514
Adjusted CNA Staffing Hours per Resident per Day
2.44973
Adjusted LPN Staffing Hours per Resident per Day
1.57180
Adjusted RN Staffing Hours per Resident per Day
0.42534
Adjusted Total Nurse Staffing Hours per Resident per Day
4.25706
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2014-10-17
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
18
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
10
Cycle 2 Health Deficiency Score
96
Cycle 2 Standard Health Survey Date
2013-12-23
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
96
Cycle 3 Total Number of Health Deficiencies
17
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
84
Cycle 3 Standard Health Survey Date
2013-01-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
84
Total Weighted Health Survey Score
86.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
11
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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