The Pavilion At Sunny Hills - Fullerton Nursing Home
General Information
UPDATEFederal Provider Number
555733
Provider Name
THE PAVILION AT SUNNY HILLS
Provider Address
2222 N. HARBOR BLVD.
FULLERTON, CA 92835
FULLERTON, CA 92835
Provider Phone Number
7149925701
Provider SSA County
400
Provider County Name
Orange
Ownership Type
For profit - Partnership
Number of Certified Beds
300
Number of Residents in Certified Beds
114
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FULLERTON HEALTHCARE & WELLNESS CENTRE LP
Date First Approved to Provide Medicare and Medicaid services
1999-01-19
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
2.42719
Reported LPN Staffing Hours per Resident per Day
0.91711
Reported RN Staffing Hours per Resident per Day
0.80702
Reported Licensed Staffing Hours per Resident per Day
1.72412
Reported Total Nurse Staffing Hours per Resident per Day
4.15132
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09254
Expected CNA Staffing Hours per Resident per Day
2.50616
Expected LPN Staffing Hours per Resident per Day
0.65641
Expected RN Staffing Hours per Resident per Day
1.05261
Expected Total Nurse Staffing Hours per Resident per Day
4.21518
Adjusted CNA Staffing Hours per Resident per Day
2.37639
Adjusted LPN Staffing Hours per Resident per Day
1.15963
Adjusted RN Staffing Hours per Resident per Day
0.57287
Adjusted Total Nurse Staffing Hours per Resident per Day
3.96983
Cycle 1 Total Number of Health Deficiencies
17
Cycle 1 Number of Standard Health Deficiencies
17
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
72
Cycle 1 Standard Survey Health Date
2014-12-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
72
Cycle 2 Total Number of Health Deficiencies
55
Cycle 2 Number of Standard Health Deficiencies
50
Cycle 2 Number of Complaint Health Deficiencies
42
Cycle 2 Health Deficiency Score
960
Cycle 2 Standard Health Survey Date
2013-10-23
Cycle 2 Number of Health Revisits
4
Cycle 2 Health Revisit Score
816
Cycle 2 Total Health Score
816
Cycle 3 Total Number of Health Deficiencies
25
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
13
Cycle 3 Health Deficiency Score
116
Cycle 3 Standard Health Survey Date
2012-10-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
116
Total Weighted Health Survey Score
647.33300
Number of Facility Reported Incidents
8
Number of Substantiated Complaints
14
Number of Fines
1
Total Amount of Fines in Dollars
147454
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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