San Pablo Healthcare And Wellness Center - San Pablo Nursing Home
General Information
UPDATEFederal Provider Number
56359
Provider Name
SAN PABLO HEALTHCARE AND WELLNESS CENTER
Provider Address
13328 SAN PABLO AVE
SAN PABLO, CA 94806
SAN PABLO, CA 94806
Provider Phone Number
(510) 235-3720
Provider SSA County
60
Provider County Name
Contra Costa
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
108
Number of Residents in Certified Beds
103
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SOLNUS FOUR, LLC
Date First Approved to Provide Medicare and Medicaid services
1972-09-29
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
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
2.26165
Reported LPN Staffing Hours per Resident per Day
0.37476
Reported RN Staffing Hours per Resident per Day
1.27379
Reported Licensed Staffing Hours per Resident per Day
1.64854
Reported Total Nurse Staffing Hours per Resident per Day
3.91020
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09272
Expected CNA Staffing Hours per Resident per Day
2.52819
Expected LPN Staffing Hours per Resident per Day
0.65104
Expected RN Staffing Hours per Resident per Day
1.13832
Expected Total Nurse Staffing Hours per Resident per Day
4.31755
Adjusted CNA Staffing Hours per Resident per Day
2.19501
Adjusted LPN Staffing Hours per Resident per Day
0.47777
Adjusted RN Staffing Hours per Resident per Day
0.83613
Adjusted Total Nurse Staffing Hours per Resident per Day
3.65060
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
230
Cycle 1 Standard Survey Health Date
2014-10-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
230
Cycle 2 Total Number of Health Deficiencies
32
Cycle 2 Number of Standard Health Deficiencies
30
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
227
Cycle 2 Standard Health Survey Date
2013-07-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
227
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2012-05-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
201.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
3
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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