Mission Carmichael Healthcare Center - Carmichael Nursing Home
General Information
UPDATEFederal Provider Number
56304
Provider Name
MISSION CARMICHAEL HEALTHCARE CENTER
Provider Address
3630 MISSION AVENUE
CARMICHAEL, CA 95608
CARMICHAEL, CA 95608
Provider Phone Number
(916) 488-1580
Provider SSA County
440
Provider County Name
Sacramento
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
135
Number of Residents in Certified Beds
119
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SSC CARMICHAEL OPERATING COMPANY LP
Date First Approved to Provide Medicare and Medicaid services
1972-01-03
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.85840
Reported LPN Staffing Hours per Resident per Day
0.56050
Reported RN Staffing Hours per Resident per Day
0.82311
Reported Licensed Staffing Hours per Resident per Day
1.38361
Reported Total Nurse Staffing Hours per Resident per Day
3.24201
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02773
Expected CNA Staffing Hours per Resident per Day
2.39951
Expected LPN Staffing Hours per Resident per Day
0.66538
Expected RN Staffing Hours per Resident per Day
1.11958
Expected Total Nurse Staffing Hours per Resident per Day
4.18447
Adjusted CNA Staffing Hours per Resident per Day
1.90037
Adjusted LPN Staffing Hours per Resident per Day
0.69917
Adjusted RN Staffing Hours per Resident per Day
0.54934
Adjusted Total Nurse Staffing Hours per Resident per Day
3.12303
Cycle 1 Total Number of Health Deficiencies
18
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
100
Cycle 1 Standard Survey Health Date
2015-01-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
100
Cycle 2 Total Number of Health Deficiencies
16
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
84
Cycle 2 Standard Health Survey Date
2014-01-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
84
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
9
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-12-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
85.33300
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
13
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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