Vista Manor Nursing Center - San Jose Nursing Home
General Information
UPDATEFederal Provider Number
555483
Provider Name
VISTA MANOR NURSING CENTER
Provider Address
120 JOSE FIGUERES AVENUE
SAN JOSE, CA 95116
SAN JOSE, CA 95116
Provider Phone Number
(408) 272-1400
Provider SSA County
530
Provider County Name
Santa Clara
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
92
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GHC OF SAN JOSE, LLC
Date First Approved to Provide Medicare and Medicaid services
1991-11-10
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
5
Overall Rating Footnote
Health Inspection Rating
3
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
2.63696
Reported LPN Staffing Hours per Resident per Day
0.55272
Reported RN Staffing Hours per Resident per Day
1.01793
Reported Licensed Staffing Hours per Resident per Day
1.57065
Reported Total Nurse Staffing Hours per Resident per Day
4.20761
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14620
Expected CNA Staffing Hours per Resident per Day
2.43368
Expected LPN Staffing Hours per Resident per Day
0.72046
Expected RN Staffing Hours per Resident per Day
1.35780
Expected Total Nurse Staffing Hours per Resident per Day
4.51193
Adjusted CNA Staffing Hours per Resident per Day
2.65866
Adjusted LPN Staffing Hours per Resident per Day
0.63676
Adjusted RN Staffing Hours per Resident per Day
0.56017
Adjusted Total Nurse Staffing Hours per Resident per Day
3.75902
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
60
Cycle 1 Standard Survey Health Date
2014-11-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
60
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2014-01-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2013-03-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
51.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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