Mt. Pleasant Nursing Center - San Jose Nursing Home
General Information
UPDATEFederal Provider Number
555799
Provider Name
MT. PLEASANT NURSING CENTER
Provider Address
1355 CLAYTON ROAD
SAN JOSE, CA 95127
SAN JOSE, CA 95127
Provider Phone Number
(408) 251-3070
Provider SSA County
530
Provider County Name
Santa Clara
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
54
Number of Residents in Certified Beds
50
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PREMIER HEALTH CARE SERVICES INC
Date First Approved to Provide Medicare and Medicaid services
2002-09-05
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
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.92000
Reported LPN Staffing Hours per Resident per Day
0.64100
Reported RN Staffing Hours per Resident per Day
0.42000
Reported Licensed Staffing Hours per Resident per Day
1.06100
Reported Total Nurse Staffing Hours per Resident per Day
3.98100
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02900
Expected CNA Staffing Hours per Resident per Day
2.09523
Expected LPN Staffing Hours per Resident per Day
0.52601
Expected RN Staffing Hours per Resident per Day
0.72613
Expected Total Nurse Staffing Hours per Resident per Day
3.34736
Adjusted CNA Staffing Hours per Resident per Day
3.41959
Adjusted LPN Staffing Hours per Resident per Day
1.01144
Adjusted RN Staffing Hours per Resident per Day
0.43219
Adjusted Total Nurse Staffing Hours per Resident per Day
4.79392
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
16
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
16
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2014-03-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2013-06-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
25.33300
Number of Facility Reported Incidents
1
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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