Lincoln Glen Skilled Nursing - San Jose Nursing Home
General Information
UPDATEFederal Provider Number
555363
Provider Name
LINCOLN GLEN SKILLED NURSING
Provider Address
2671 PLUMMER AVENUE
SAN JOSE, CA 95125
SAN JOSE, CA 95125
Provider Phone Number
(408) 265-3222
Provider SSA County
530
Provider County Name
Santa Clara
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
59
Number of Residents in Certified Beds
55
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1989-07-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
5
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
2.65182
Reported LPN Staffing Hours per Resident per Day
0.73636
Reported RN Staffing Hours per Resident per Day
0.81091
Reported Licensed Staffing Hours per Resident per Day
1.54727
Reported Total Nurse Staffing Hours per Resident per Day
4.19909
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02636
Expected CNA Staffing Hours per Resident per Day
2.52779
Expected LPN Staffing Hours per Resident per Day
0.56450
Expected RN Staffing Hours per Resident per Day
0.82372
Expected Total Nurse Staffing Hours per Resident per Day
3.91601
Adjusted CNA Staffing Hours per Resident per Day
2.57409
Adjusted LPN Staffing Hours per Resident per Day
1.08269
Adjusted RN Staffing Hours per Resident per Day
0.73558
Adjusted Total Nurse Staffing Hours per Resident per Day
4.32229
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-08-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-10-25
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
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-10-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
21.33300
Number of Facility Reported Incidents
3
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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