Pacifica Nursing And Rehab Center - Pacifica Nursing Home
General Information
UPDATEFederal Provider Number
56205
Provider Name
PACIFICA NURSING AND REHAB CENTER
Provider Address
385 ESPLANADE AVENUE
PACIFICA, CA 94044
PACIFICA, CA 94044
Provider Phone Number
(650) 993-5576
Provider SSA County
41
Provider County Name
San Mateo
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
68
Number of Residents in Certified Beds
61
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
1970-05-13
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
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
4.46230
Reported LPN Staffing Hours per Resident per Day
1.29672
Reported RN Staffing Hours per Resident per Day
2.08197
Reported Licensed Staffing Hours per Resident per Day
3.37869
Reported Total Nurse Staffing Hours per Resident per Day
7.84099
Reported Physical Therapist Staffing Hours per Resident Per Day
0.64918
Expected CNA Staffing Hours per Resident per Day
2.69479
Expected LPN Staffing Hours per Resident per Day
0.83846
Expected RN Staffing Hours per Resident per Day
1.69828
Expected Total Nurse Staffing Hours per Resident per Day
5.23153
Adjusted CNA Staffing Hours per Resident per Day
4.06308
Adjusted LPN Staffing Hours per Resident per Day
1.28364
Adjusted RN Staffing Hours per Resident per Day
0.91601
Adjusted Total Nurse Staffing Hours per Resident per Day
6.04149
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-08-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-08-08
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-08-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
36.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
2
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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