St Jude Care Center - Manteca Nursing Home
General Information
UPDATEFederal Provider Number
55917
Provider Name
ST JUDE CARE CENTER
Provider Address
469 EAST NORTH STREET
MANTECA, CA 95336
MANTECA, CA 95336
Provider Phone Number
(209) 823-1788
Provider SSA County
490
Provider County Name
San Joaquin
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
82
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PALM HAVEN NURSING & REHAB LLC
Date First Approved to Provide Medicare and Medicaid services
1968-04-10
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.55061
Reported LPN Staffing Hours per Resident per Day
0.71890
Reported RN Staffing Hours per Resident per Day
0.41829
Reported Licensed Staffing Hours per Resident per Day
1.13720
Reported Total Nurse Staffing Hours per Resident per Day
3.68780
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10305
Expected CNA Staffing Hours per Resident per Day
2.50927
Expected LPN Staffing Hours per Resident per Day
0.56999
Expected RN Staffing Hours per Resident per Day
0.90098
Expected Total Nurse Staffing Hours per Resident per Day
3.98023
Adjusted CNA Staffing Hours per Resident per Day
2.49413
Adjusted LPN Staffing Hours per Resident per Day
1.04684
Adjusted RN Staffing Hours per Resident per Day
0.34690
Adjusted Total Nurse Staffing Hours per Resident per Day
3.73474
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-11-06
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
88
Cycle 2 Standard Health Survey Date
2014-01-09
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
88
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
116
Cycle 3 Standard Health Survey Date
2013-01-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
116
Total Weighted Health Survey Score
70.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
1
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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