Shea Family Care South Bay - Chula Vista Nursing Home
General Information
UPDATEFederal Provider Number
555873
Provider Name
SHEA FAMILY CARE SOUTH BAY
Provider Address
553 F STREET
CHULA VISTA, CA 91910
CHULA VISTA, CA 91910
Provider Phone Number
(619) 426-8611
Provider SSA County
470
Provider County Name
San Diego
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
64
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
2011-07-23
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
3
QM Rating Footnote
Staffing Rating
5
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
2.50156
Reported LPN Staffing Hours per Resident per Day
1.30391
Reported RN Staffing Hours per Resident per Day
1.40625
Reported Licensed Staffing Hours per Resident per Day
2.71016
Reported Total Nurse Staffing Hours per Resident per Day
5.21172
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12734
Expected CNA Staffing Hours per Resident per Day
2.63322
Expected LPN Staffing Hours per Resident per Day
0.64208
Expected RN Staffing Hours per Resident per Day
1.08418
Expected Total Nurse Staffing Hours per Resident per Day
4.35948
Adjusted CNA Staffing Hours per Resident per Day
2.33101
Adjusted LPN Staffing Hours per Resident per Day
1.68554
Adjusted RN Staffing Hours per Resident per Day
0.96917
Adjusted Total Nurse Staffing Hours per Resident per Day
4.81891
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-05-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
27
Cycle 2 Number of Standard Health Deficiencies
16
Cycle 2 Number of Complaint Health Deficiencies
11
Cycle 2 Health Deficiency Score
317
Cycle 2 Standard Health Survey Date
2013-06-04
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
317
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-05-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
133.00000
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
6
Number of Fines
1
Total Amount of Fines in Dollars
18753
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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