Vista Cove Care Center At San Gabriel - San Gabriel Nursing Home

General Information

UPDATE
Federal Provider Number
55105
Provider Name
VISTA COVE CARE CENTER AT SAN GABRIEL
Provider Address
909 W. SANTA ANITA STREET
SAN GABRIEL, CA 91776
Provider Phone Number
(626) 289-5365
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
88
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
VISTA COVE CARE CENTER AT SAN GABRIEL, INC.
Date First Approved to Provide Medicare and Medicaid services
1973-01-01
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.13523
Reported LPN Staffing Hours per Resident per Day
0.73636
Reported RN Staffing Hours per Resident per Day
0.59659
Reported Licensed Staffing Hours per Resident per Day
1.33295
Reported Total Nurse Staffing Hours per Resident per Day
3.46818
Reported Physical Therapist Staffing Hours per Resident Per Day
0.13807
Expected CNA Staffing Hours per Resident per Day
2.51318
Expected LPN Staffing Hours per Resident per Day
0.64914
Expected RN Staffing Hours per Resident per Day
1.16388
Expected Total Nurse Staffing Hours per Resident per Day
4.32620
Adjusted CNA Staffing Hours per Resident per Day
2.08470
Adjusted LPN Staffing Hours per Resident per Day
0.94152
Adjusted RN Staffing Hours per Resident per Day
0.38300
Adjusted Total Nurse Staffing Hours per Resident per Day
3.23145
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2015-01-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
19
Cycle 2 Number of Standard Health Deficiencies
19
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
112
Cycle 2 Standard Health Survey Date
2013-06-22
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
56
Cycle 2 Total Health Score
168
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2012-03-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
100.00000
Number of Facility Reported Incidents
0
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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