Mills-peninsula Skilled Nursing - Burlingame Nursing Home
General Information
UPDATEFederal Provider Number
555856
Provider Name
MILLS-PENINSULA SKILLED NURSING
Provider Address
1609 TROUSDALE DRIVE
BURLINGAME, CA 94010
BURLINGAME, CA 94010
Provider Phone Number
(650) 696-5270
Provider SSA County
510
Provider County Name
San Mateo
Provider Website
Provider Description
Ownership Type
Non profit - Other
Number of Certified Beds
62
Number of Residents in Certified Beds
31
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
2008-12-22
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
5
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
3.62903
Reported LPN Staffing Hours per Resident per Day
1.05968
Reported RN Staffing Hours per Resident per Day
3.08871
Reported Licensed Staffing Hours per Resident per Day
4.14839
Reported Total Nurse Staffing Hours per Resident per Day
7.77742
Reported Physical Therapist Staffing Hours per Resident Per Day
0.48387
Expected CNA Staffing Hours per Resident per Day
2.32894
Expected LPN Staffing Hours per Resident per Day
0.91045
Expected RN Staffing Hours per Resident per Day
1.96246
Expected Total Nurse Staffing Hours per Resident per Day
5.20184
Adjusted CNA Staffing Hours per Resident per Day
3.82344
Adjusted LPN Staffing Hours per Resident per Day
0.96604
Adjusted RN Staffing Hours per Resident per Day
1.17602
Adjusted Total Nurse Staffing Hours per Resident per Day
6.02671
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2015-02-06
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
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-12-30
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
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2013-01-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
24.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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