St John Kronstadt Convalescent Center - Castro Valley Nursing Home

General Information

UPDATE
Federal Provider Number
555016
Provider Name
ST JOHN KRONSTADT CONVALESCENT CENTER
Provider Address
4432 JAMES AVENUE
CASTRO VALLEY, CA 94546
Provider Phone Number
(510) 889-7000
Provider SSA County
0
Provider County Name
Alameda
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
49
Number of Residents in Certified Beds
42
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ST JOHN KRONSTADT HOME FOR AGED RUSSIAN AMERICANS
Date First Approved to Provide Medicare and Medicaid services
1976-05-14
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
5
Overall Rating Footnote
Health Inspection Rating
4
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
2.47619
Reported LPN Staffing Hours per Resident per Day
0.51667
Reported RN Staffing Hours per Resident per Day
0.78929
Reported Licensed Staffing Hours per Resident per Day
1.30595
Reported Total Nurse Staffing Hours per Resident per Day
3.78215
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08452
Expected CNA Staffing Hours per Resident per Day
2.41474
Expected LPN Staffing Hours per Resident per Day
0.56067
Expected RN Staffing Hours per Resident per Day
0.87709
Expected Total Nurse Staffing Hours per Resident per Day
3.85251
Adjusted CNA Staffing Hours per Resident per Day
2.51614
Adjusted LPN Staffing Hours per Resident per Day
0.76486
Adjusted RN Staffing Hours per Resident per Day
0.67240
Adjusted Total Nurse Staffing Hours per Resident per Day
3.95728
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-08-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-06-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-04-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
24.66700
Number of Facility Reported Incidents
2
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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