St Edna Subacute And Rehabilitation Center - Santa Ana Nursing Home
General Information
UPDATEFederal Provider Number
555093
Provider Name
ST EDNA SUBACUTE AND REHABILITATION CENTER
Provider Address
1929 N. FAIRVIEW STREET
SANTA ANA, CA 92706
SANTA ANA, CA 92706
Provider Phone Number
(714) 554-9700
Provider SSA County
400
Provider County Name
Orange
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
144
Number of Residents in Certified Beds
132
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COVENANT CARE CALIFORNIA, LLC
Date First Approved to Provide Medicare and Medicaid services
1978-08-11
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
3
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
2.29167
Reported LPN Staffing Hours per Resident per Day
0.81629
Reported RN Staffing Hours per Resident per Day
0.66061
Reported Licensed Staffing Hours per Resident per Day
1.47689
Reported Total Nurse Staffing Hours per Resident per Day
3.76857
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08220
Expected CNA Staffing Hours per Resident per Day
2.76760
Expected LPN Staffing Hours per Resident per Day
0.69164
Expected RN Staffing Hours per Resident per Day
1.14354
Expected Total Nurse Staffing Hours per Resident per Day
4.60278
Adjusted CNA Staffing Hours per Resident per Day
2.03175
Adjusted LPN Staffing Hours per Resident per Day
0.97958
Adjusted RN Staffing Hours per Resident per Day
0.43165
Adjusted Total Nurse Staffing Hours per Resident per Day
3.30034
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2015-02-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
17
Cycle 2 Number of Standard Health Deficiencies
17
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2013-12-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
56
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-11-07
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
55.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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