Skyline Healthcare Center - San Jose - San Jose Nursing Home
General Information
UPDATEFederal Provider Number
55318
Provider Name
SKYLINE HEALTHCARE CENTER - SAN JOSE
Provider Address
2065 FOREST AVENUE
SAN JOSE, CA 95128
SAN JOSE, CA 95128
Provider Phone Number
4082802500
Provider SSA County
530
Provider County Name
Santa Clara
Ownership Type
For profit - Corporation
Number of Certified Beds
253
Number of Residents in Certified Beds
232
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SKYLINE SAN JOSE OPERATING COMPANY LP
Date First Approved to Provide Medicare and Medicaid services
1974-03-31
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
4
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
2.59159
Reported LPN Staffing Hours per Resident per Day
0.51875
Reported RN Staffing Hours per Resident per Day
1.17328
Reported Licensed Staffing Hours per Resident per Day
1.69203
Reported Total Nurse Staffing Hours per Resident per Day
4.28362
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05108
Expected CNA Staffing Hours per Resident per Day
2.52125
Expected LPN Staffing Hours per Resident per Day
0.65652
Expected RN Staffing Hours per Resident per Day
1.00639
Expected Total Nurse Staffing Hours per Resident per Day
4.18416
Adjusted CNA Staffing Hours per Resident per Day
2.52215
Adjusted LPN Staffing Hours per Resident per Day
0.65583
Adjusted RN Staffing Hours per Resident per Day
0.87111
Adjusted Total Nurse Staffing Hours per Resident per Day
4.12671
Cycle 1 Total Number of Health Deficiencies
27
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
14
Cycle 1 Health Deficiency Score
132
Cycle 1 Standard Survey Health Date
2014-09-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
132
Cycle 2 Total Number of Health Deficiencies
19
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
8
Cycle 2 Health Deficiency Score
80
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
0
Cycle 3 Total Number of Health Deficiencies
16
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
8
Cycle 3 Health Deficiency Score
88
Cycle 3 Standard Health Survey Date
2013-03-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
88
Total Weighted Health Survey Score
107.33300
Number of Facility Reported Incidents
19
Number of Substantiated Complaints
15
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
Nursiong Homes Nearby
O'connor Hospital Dp/snf
2105 Forest Avenue |
SAN JOSE CA 95128 | 0.2 mile away
Mission Skilled Nursing & Subacute Center
410 North Winchester Boulevard |
SANTA CLARA CA 95050 | 1 mile away
White Blossom Care Center
1990 Fruitdale Avenue |
SAN JOSE CA 95128 | 1.3 miles away
Empress Care Center, Llc
1299 S. Bascom Avenue |
SAN JOSE CA 95128 | 1.8 miles away
Courtyard Care Center
340 Northlake Drive |
SAN JOSE CA 95117 | 1.9 miles away
A Grace Sub Acute & Skilled Care
1250 S. Winchester Boulevard |
SAN JOSE CA 95128 | 1.9 miles away
Willow Glen Center
1267 Meridian Avenue |
SAN JOSE CA 95125 | 2.1 miles away
San Tomas Convalescent Hospital
3580 Payne Avenue |
SAN JOSE CA 95117 | 2.4 miles away
San Jose Healthcare & Wellness Center
75 N. 13th Street |
SAN JOSE CA 95112 | 3.2 miles away
Greenhills Manor
238 Virginia Avenue |
CAMPBELL CA 95008 | 3.4 miles away
Herman Health Care Center
2295 Plummer Avenue |
SAN JOSE CA 95125 | 3.7 miles away
Camden Convalescent Hospital
1331 Camden Avenue |
CAMPBELL CA 95008 | 4.1 miles away
Lincoln Glen Skilled Nursing
2671 Plummer Avenue |
SAN JOSE CA 95125 | 4.1 miles away
Amberwood Gardens
1601 Petersen Avenue |
SAN JOSE CA 95129 | 4.2 miles away
Valley House Rehabilitation Center
991 Clyde Avenue |
SANTA CLARA CA 95054 | 4.4 miles away
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