St. Francis Convalescent Pavilion - Daly City Nursing Home
General Information
UPDATEFederal Provider Number
56394
Provider Name
ST. FRANCIS CONVALESCENT PAVILION
Provider Address
99 ESCUELA DRIVE
DALY CITY, CA 94015
DALY CITY, CA 94015
Provider Phone Number
(650) 994-3200
Provider SSA County
510
Provider County Name
San Mateo
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
239
Number of Residents in Certified Beds
220
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GHC OF DALY CITY 239, LLC
Date First Approved to Provide Medicare and Medicaid services
1973-07-16
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
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
2.73864
Reported LPN Staffing Hours per Resident per Day
0.70568
Reported RN Staffing Hours per Resident per Day
0.80864
Reported Licensed Staffing Hours per Resident per Day
1.51432
Reported Total Nurse Staffing Hours per Resident per Day
4.25296
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08773
Expected CNA Staffing Hours per Resident per Day
2.46750
Expected LPN Staffing Hours per Resident per Day
0.62566
Expected RN Staffing Hours per Resident per Day
0.95905
Expected Total Nurse Staffing Hours per Resident per Day
4.05221
Adjusted CNA Staffing Hours per Resident per Day
2.72332
Adjusted LPN Staffing Hours per Resident per Day
0.93615
Adjusted RN Staffing Hours per Resident per Day
0.63002
Adjusted Total Nurse Staffing Hours per Resident per Day
4.23060
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-09-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
24
Cycle 2 Number of Standard Health Deficiencies
19
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
152
Cycle 2 Standard Health Survey Date
2013-09-25
Cycle 2 Number of Health Revisits
3
Cycle 2 Health Revisit Score
106
Cycle 2 Total Health Score
258
Cycle 3 Total Number of Health Deficiencies
17
Cycle 3 Number of Standard Health Deficiencies
15
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
108
Cycle 3 Standard Health Survey Date
2012-10-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
108
Total Weighted Health Survey Score
142.00000
Number of Facility Reported Incidents
5
Number of Substantiated Complaints
7
Number of Fines
1
Total Amount of Fines in Dollars
20000
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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