Los Altos Sub-acute And Rehabilitation Center - Los Altos Nursing Home
General Information
UPDATEFederal Provider Number
56116
Provider Name
LOS ALTOS SUB-ACUTE AND REHABILITATION CENTER
Provider Address
809 FREMONT AVENUE
LOS ALTOS, CA 94024
LOS ALTOS, CA 94024
Provider Phone Number
(650) 941-5255
Provider SSA County
530
Provider County Name
Santa Clara
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
152
Number of Residents in Certified Beds
141
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COVENANT CARE CALIFORNIA, LLC
Date First Approved to Provide Medicare and Medicaid services
1971-12-31
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
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.18227
Reported LPN Staffing Hours per Resident per Day
0.41383
Reported RN Staffing Hours per Resident per Day
1.27199
Reported Licensed Staffing Hours per Resident per Day
1.68582
Reported Total Nurse Staffing Hours per Resident per Day
3.86809
Reported Physical Therapist Staffing Hours per Resident Per Day
0.20638
Expected CNA Staffing Hours per Resident per Day
2.38761
Expected LPN Staffing Hours per Resident per Day
0.67491
Expected RN Staffing Hours per Resident per Day
1.29449
Expected Total Nurse Staffing Hours per Resident per Day
4.35701
Adjusted CNA Staffing Hours per Resident per Day
2.24268
Adjusted LPN Staffing Hours per Resident per Day
0.50893
Adjusted RN Staffing Hours per Resident per Day
0.73421
Adjusted Total Nurse Staffing Hours per Resident per Day
3.57858
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-09-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
80
Cycle 2 Standard Health Survey Date
2013-09-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
80
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
36
Cycle 3 Standard Health Survey Date
2012-10-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
60.66700
Number of Facility Reported Incidents
4
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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