San Bruno Skilled Nursing Hospital - San Bruno Nursing Home

General Information

UPDATE
Federal Provider Number
555276
Provider Name
SAN BRUNO SKILLED NURSING HOSPITAL
Provider Address
890 EL CAMINO REAL
SAN BRUNO, CA 94066
Provider Phone Number
(650) 583-7768
Provider SSA County
510
Provider County Name
San Mateo
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
45
Number of Residents in Certified Beds
43
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SAN BRUNO SKILLED NURSING HOSPITAL, INC.
Date First Approved to Provide Medicare and Medicaid services
1987-02-27
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
2.59884
Reported LPN Staffing Hours per Resident per Day
0.56512
Reported RN Staffing Hours per Resident per Day
0.70465
Reported Licensed Staffing Hours per Resident per Day
1.26977
Reported Total Nurse Staffing Hours per Resident per Day
3.86861
Reported Physical Therapist Staffing Hours per Resident Per Day
0.17093
Expected CNA Staffing Hours per Resident per Day
2.54565
Expected LPN Staffing Hours per Resident per Day
0.66764
Expected RN Staffing Hours per Resident per Day
0.98968
Expected Total Nurse Staffing Hours per Resident per Day
4.20297
Adjusted CNA Staffing Hours per Resident per Day
2.50497
Adjusted LPN Staffing Hours per Resident per Day
0.70255
Adjusted RN Staffing Hours per Resident per Day
0.53201
Adjusted Total Nurse Staffing Hours per Resident per Day
3.71023
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2014-12-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-12-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
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
2012-11-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
39.33300
Number of Facility Reported Incidents
0
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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