Mission De La Casa Nursing & Rehabilitation Center - San Jose Nursing Home
General Information
UPDATEFederal Provider Number
555487
Provider Name
MISSION DE LA CASA NURSING & REHABILITATION CENTER
Provider Address
2501 ALVIN AVENUE
SAN JOSE, CA 95121
SAN JOSE, CA 95121
Provider Phone Number
(408) 238-9751
Provider SSA County
530
Provider County Name
Santa Clara
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
163
Number of Residents in Certified Beds
154
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CASAVINA FOUNDATION CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1991-12-17
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
4
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
2.90487
Reported LPN Staffing Hours per Resident per Day
0.57987
Reported RN Staffing Hours per Resident per Day
0.77662
Reported Licensed Staffing Hours per Resident per Day
1.35649
Reported Total Nurse Staffing Hours per Resident per Day
4.26136
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02890
Expected CNA Staffing Hours per Resident per Day
2.29895
Expected LPN Staffing Hours per Resident per Day
0.55468
Expected RN Staffing Hours per Resident per Day
0.82933
Expected Total Nurse Staffing Hours per Resident per Day
3.68296
Adjusted CNA Staffing Hours per Resident per Day
3.10041
Adjusted LPN Staffing Hours per Resident per Day
0.86770
Adjusted RN Staffing Hours per Resident per Day
0.69971
Adjusted Total Nurse Staffing Hours per Resident per Day
4.66394
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2014-05-28
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
19
Cycle 2 Number of Standard Health Deficiencies
17
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
116
Cycle 2 Standard Health Survey Date
2013-05-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
116
Cycle 3 Total Number of Health Deficiencies
18
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
96
Cycle 3 Standard Health Survey Date
2012-07-16
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
96
Total Weighted Health Survey Score
86.66700
Number of Facility Reported Incidents
5
Number of Substantiated Complaints
5
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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