Medical Center Conv Hosp - San Bernardino Nursing Home

General Information

UPDATE
Federal Provider Number
56436
Provider Name
MEDICAL CENTER CONV HOSP
Provider Address
467 E GILBERT ST
SAN BERNARDINO, CA 92404
Provider Phone Number
9098844781
Provider SSA County
460
Provider County Name
San Bernardino
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
89
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
1974-04-11
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.71854
Reported LPN Staffing Hours per Resident per Day
1.05000
Reported RN Staffing Hours per Resident per Day
0.34663
Reported Licensed Staffing Hours per Resident per Day
1.39663
Reported Total Nurse Staffing Hours per Resident per Day
4.11517
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07697
Expected CNA Staffing Hours per Resident per Day
2.33393
Expected LPN Staffing Hours per Resident per Day
0.63238
Expected RN Staffing Hours per Resident per Day
0.94866
Expected Total Nurse Staffing Hours per Resident per Day
3.91498
Adjusted CNA Staffing Hours per Resident per Day
2.85804
Adjusted LPN Staffing Hours per Resident per Day
1.37812
Adjusted RN Staffing Hours per Resident per Day
0.27302
Adjusted Total Nurse Staffing Hours per Resident per Day
4.23702
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
96
Cycle 1 Standard Survey Health Date
2014-08-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
96
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-11-08
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
25
Cycle 3 Number of Standard Health Deficiencies
25
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
237
Cycle 3 Standard Health Survey Date
2012-10-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
237
Total Weighted Health Survey Score
104.83300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
41600
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01

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