Thousand Oaks Healthcare Center - Thousand Oaks Nursing Home
General Information
UPDATEFederal Provider Number
55342
Provider Name
THOUSAND OAKS HEALTHCARE CENTER
Provider Address
93 W AVENIDA DE LOS ARBOLES
THOUSAND OAKS, CA 91360
THOUSAND OAKS, CA 91360
Provider Phone Number
(805) 492-2444
Provider SSA County
660
Provider County Name
Ventura
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
123
Number of Residents in Certified Beds
89
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FIVE STAR QUALITY CARE-CA II LLC
Date First Approved to Provide Medicare and Medicaid services
1971-03-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
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
2.33764
Reported LPN Staffing Hours per Resident per Day
0.51292
Reported RN Staffing Hours per Resident per Day
0.80056
Reported Licensed Staffing Hours per Resident per Day
1.31348
Reported Total Nurse Staffing Hours per Resident per Day
3.65112
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12360
Expected CNA Staffing Hours per Resident per Day
2.67931
Expected LPN Staffing Hours per Resident per Day
0.64848
Expected RN Staffing Hours per Resident per Day
0.98128
Expected Total Nurse Staffing Hours per Resident per Day
4.30907
Adjusted CNA Staffing Hours per Resident per Day
2.14080
Adjusted LPN Staffing Hours per Resident per Day
0.65649
Adjusted RN Staffing Hours per Resident per Day
0.60959
Adjusted Total Nurse Staffing Hours per Resident per Day
3.41542
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
2015-01-15
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
24
Cycle 2 Number of Standard Health Deficiencies
22
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
366
Cycle 2 Standard Health Survey Date
2014-01-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
366
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
7
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2013-03-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
141.33300
Number of Facility Reported Incidents
4
Number of Substantiated Complaints
9
Number of Fines
1
Total Amount of Fines in Dollars
23350
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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