Samarkand Skilled Nursing Facility - Santa Barbara Nursing Home
General Information
UPDATEFederal Provider Number
555762
Provider Name
SAMARKAND SKILLED NURSING FACILITY
Provider Address
2566 TREASURE DR
SANTA BARBARA, CA 93105
SANTA BARBARA, CA 93105
Provider Phone Number
(805) 687-0701
Provider SSA County
520
Provider County Name
Santa Barbara
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
63
Number of Residents in Certified Beds
61
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COVENANT RETIREMENT COMMUNITIES WEST
Date First Approved to Provide Medicare and Medicaid services
2000-08-21
Continuing Care Retirement Community
Y
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
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.72951
Reported LPN Staffing Hours per Resident per Day
0.66639
Reported RN Staffing Hours per Resident per Day
0.82951
Reported Licensed Staffing Hours per Resident per Day
1.49590
Reported Total Nurse Staffing Hours per Resident per Day
4.22541
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09262
Expected CNA Staffing Hours per Resident per Day
2.69753
Expected LPN Staffing Hours per Resident per Day
0.61241
Expected RN Staffing Hours per Resident per Day
0.93925
Expected Total Nurse Staffing Hours per Resident per Day
4.24919
Adjusted CNA Staffing Hours per Resident per Day
2.48279
Adjusted LPN Staffing Hours per Resident per Day
0.90316
Adjusted RN Staffing Hours per Resident per Day
0.65990
Adjusted Total Nurse Staffing Hours per Resident per Day
4.00835
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-09-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
6
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-09-20
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-09-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
30.66700
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
6
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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