San Tomas Convalescent Hospital - San Jose Nursing Home
General Information
UPDATEFederal Provider Number
55884
Provider Name
SAN TOMAS CONVALESCENT HOSPITAL
Provider Address
3580 PAYNE AVENUE
SAN JOSE, CA 95117
SAN JOSE, CA 95117
Provider Phone Number
(408) 248-7100
Provider SSA County
530
Provider County Name
Santa Clara
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
130
Number of Residents in Certified Beds
117
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
AQUINAS CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1968-03-12
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
4
Overall Rating Footnote
Health Inspection Rating
2
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
2.83504
Reported LPN Staffing Hours per Resident per Day
0.52265
Reported RN Staffing Hours per Resident per Day
0.75598
Reported Licensed Staffing Hours per Resident per Day
1.27863
Reported Total Nurse Staffing Hours per Resident per Day
4.11367
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06795
Expected CNA Staffing Hours per Resident per Day
2.40100
Expected LPN Staffing Hours per Resident per Day
0.59115
Expected RN Staffing Hours per Resident per Day
0.89882
Expected Total Nurse Staffing Hours per Resident per Day
3.89097
Adjusted CNA Staffing Hours per Resident per Day
2.89727
Adjusted LPN Staffing Hours per Resident per Day
0.73383
Adjusted RN Staffing Hours per Resident per Day
0.62846
Adjusted Total Nurse Staffing Hours per Resident per Day
4.26161
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-06-03
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
112
Cycle 2 Standard Health Survey Date
2013-08-26
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
112
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2012-08-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
61.33300
Number of Facility Reported Incidents
4
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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