San Jose Healthcare Center - San Jose Nursing Home
General Information
UPDATEFederal Provider Number
56082
Provider Name
SAN JOSE HEALTHCARE CENTER
Provider Address
180 NORTH JACKSON AVENUE
SAN JOSE, CA 95116
SAN JOSE, CA 95116
Provider Phone Number
(408) 259-8700
Provider SSA County
530
Provider County Name
Santa Clara
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
199
Number of Residents in Certified Beds
179
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LIFEHOUSE SAN JOSE OPERATIONS, LLC
Date First Approved to Provide Medicare and Medicaid services
1994-12-30
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
2.55279
Reported LPN Staffing Hours per Resident per Day
0.60978
Reported RN Staffing Hours per Resident per Day
0.56425
Reported Licensed Staffing Hours per Resident per Day
1.17402
Reported Total Nurse Staffing Hours per Resident per Day
3.72682
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06397
Expected CNA Staffing Hours per Resident per Day
2.48404
Expected LPN Staffing Hours per Resident per Day
0.63050
Expected RN Staffing Hours per Resident per Day
0.91329
Expected Total Nurse Staffing Hours per Resident per Day
4.02784
Adjusted CNA Staffing Hours per Resident per Day
2.52161
Adjusted LPN Staffing Hours per Resident per Day
0.80272
Adjusted RN Staffing Hours per Resident per Day
0.46164
Adjusted Total Nurse Staffing Hours per Resident per Day
3.72966
Cycle 1 Total Number of Health Deficiencies
26
Cycle 1 Number of Standard Health Deficiencies
16
Cycle 1 Number of Complaint Health Deficiencies
11
Cycle 1 Health Deficiency Score
156
Cycle 1 Standard Survey Health Date
2015-04-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
156
Cycle 2 Total Number of Health Deficiencies
42
Cycle 2 Number of Standard Health Deficiencies
30
Cycle 2 Number of Complaint Health Deficiencies
12
Cycle 2 Health Deficiency Score
212
Cycle 2 Standard Health Survey Date
2014-05-09
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
212
Cycle 3 Total Number of Health Deficiencies
26
Cycle 3 Number of Standard Health Deficiencies
22
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
128
Cycle 3 Standard Health Survey Date
2013-06-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
128
Total Weighted Health Survey Score
170.00000
Number of Facility Reported Incidents
12
Number of Substantiated Complaints
12
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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