St Elizabeth Healthcare Center - Fullerton Nursing Home
General Information
UPDATEFederal Provider Number
55570
Provider Name
ST ELIZABETH HEALTHCARE CENTER
Provider Address
2800 N. HARBOR BLVD.
FULLERTON, CA 92835
FULLERTON, CA 92835
Provider Phone Number
(714) 871-9202
Provider SSA County
400
Provider County Name
Orange
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
59
Number of Residents in Certified Beds
54
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ST. ELIZABETH HEALTHCARE AND REHABILITATION CENTER, LLC
Date First Approved to Provide Medicare and Medicaid services
1977-05-01
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
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.98981
Reported LPN Staffing Hours per Resident per Day
0.55648
Reported RN Staffing Hours per Resident per Day
1.33241
Reported Licensed Staffing Hours per Resident per Day
1.88889
Reported Total Nurse Staffing Hours per Resident per Day
3.87870
Reported Physical Therapist Staffing Hours per Resident Per Day
0.17037
Expected CNA Staffing Hours per Resident per Day
2.49697
Expected LPN Staffing Hours per Resident per Day
0.71395
Expected RN Staffing Hours per Resident per Day
1.29375
Expected Total Nurse Staffing Hours per Resident per Day
4.50467
Adjusted CNA Staffing Hours per Resident per Day
1.95533
Adjusted LPN Staffing Hours per Resident per Day
0.64693
Adjusted RN Staffing Hours per Resident per Day
0.76953
Adjusted Total Nurse Staffing Hours per Resident per Day
3.47076
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
44
Cycle 1 Standard Survey Health Date
2014-05-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
14
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-07-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
52
Cycle 3 Total Number of Health Deficiencies
16
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
80
Cycle 3 Standard Health Survey Date
2012-09-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
80
Total Weighted Health Survey Score
52.66700
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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