Willow Glen Center - San Jose Nursing Home
General Information
UPDATEFederal Provider Number
56212
Provider Name
WILLOW GLEN CENTER
Provider Address
1267 MERIDIAN AVENUE
SAN JOSE, CA 95125
SAN JOSE, CA 95125
Provider Phone Number
(408) 265-4211
Provider SSA County
530
Provider County Name
Santa Clara
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
152
Number of Residents in Certified Beds
115
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BETTER CARE INC
Date First Approved to Provide Medicare and Medicaid services
1970-05-06
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
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
3.03043
Reported LPN Staffing Hours per Resident per Day
0.78000
Reported RN Staffing Hours per Resident per Day
0.89000
Reported Licensed Staffing Hours per Resident per Day
1.67000
Reported Total Nurse Staffing Hours per Resident per Day
4.70043
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09870
Expected CNA Staffing Hours per Resident per Day
2.51861
Expected LPN Staffing Hours per Resident per Day
0.64259
Expected RN Staffing Hours per Resident per Day
1.04386
Expected Total Nurse Staffing Hours per Resident per Day
4.20507
Adjusted CNA Staffing Hours per Resident per Day
2.95233
Adjusted LPN Staffing Hours per Resident per Day
1.00748
Adjusted RN Staffing Hours per Resident per Day
0.63706
Adjusted Total Nurse Staffing Hours per Resident per Day
4.50575
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-09-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-11-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
52
Cycle 3 Total Number of Health Deficiencies
18
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
11
Cycle 3 Health Deficiency Score
88
Cycle 3 Standard Health Survey Date
2012-10-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
88
Total Weighted Health Survey Score
52.00000
Number of Facility Reported Incidents
13
Number of Substantiated Complaints
5
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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