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Detailed information-PRINCETON MANOR HEALTHCARE CENTER, LLC

This is the detailed information about PRINCETON MANOR HEALTHCARE CENTER, LLC, including its zip code, address, phone, federal provider number, state, overall rating, etc.

Federal Provider Number: 055876
Provider State: CA
Provider Zip Code: 94621
Overall Rating: 4
Ownership Type: For profit - Partnership
Number of Substantiated Complaints: 11
Provider Phone Number: 5102612628
Provider City: OAKLAND
Provider SSA County Code: 000
Provider County Name: Alameda
Provider Address: 2124 57TH AVENUE
Number of Certified Beds: 82
Number of Residents in Certified Beds: 77.1
Provider Type: Medicare and Medicaid
Provider Resides in Hospital: N
Date First Approved to Provide Medicare and Medicaid services: 1968-01-18
Continuing Care Retirement Community: N
Special Focus Facility: N
Most Recent Health Inspection More Than 2 Years Ago: N

Provider Changed Ownership in Last 12 Months: N
With a Resident and Family Council: Both
Automatic Sprinkler Systems in All Required Areas: Yes
Overall Rating Footnote:
Health Inspection Rating: 3
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: 1.72628
Reported LPN Staffing Hours per Resident per Day: 0.58953
Reported RN Staffing Hours per Resident per Day: 0.45887
Reported Licensed Staffing Hours per Resident per Day: 1.04840
Reported Total Nurse Staffing Hours per Resident per Day: 2.77468
Reported Physical Therapist Staffing Hours per Resident Per Day: 0.09137
Expected CNA Staffing Hours per Resident per Day: 1.87746
Expected LPN Staffing Hours per Resident per Day: 0.72231
Expected RN Staffing Hours per Resident per Day: 0.33970
Expected Total Nurse Staffing Hours per Resident per Day: 2.93947

Adjusted CNA Staffing Hours per Resident per Day: 1.92101
Adjusted LPN Staffing Hours per Resident per Day: 0.61936
Adjusted RN Staffing Hours per Resident per Day: 0.51386
Adjusted Total Nurse Staffing Hours per Resident per Day: 3.04752
Health Survey Date Under New Process: No Health Inspection since 11/28/2017
Number of Health Deficiencies on Survey Under New Process: Not Applicable
Severity of Most Severe Deficiency Cited Under New Process: Not Applicable
Largest Number of Residents Affected by Deficiency Cited Under New Process: Not Applicable
Date of Previous Standard Health Inspection: 11/09/2017
Number of Health Deficiencies on Previous Standard Health Inspection: 9
Rating Cycle 1 Standard Survey Health Date: 2017-11-09
Rating Cycle 1 Total Number of Health Deficiencies: 10
Rating Cycle 1 Number of Standard Health Deficiencies: 9
Rating Cycle 1 Number of Complaint Health Deficiencies: 1
Rating Cycle 1 Health Deficiency Score: 52
Rating Cycle 1 Number of Health Revisits: 1
Rating Cycle 1 Health Revisit Score: 0
Rating Cycle 1 Total Health Score: 52

Rating Cycle 2 Standard Health Survey Date: 2016-11-17
Rating Cycle 2 Total Number of Health Deficiencies: 18
Rating Cycle 2 Number of Standard Health Deficiencies: 9
Rating Cycle 2 Number of Complaint Health Deficiencies: 10
Rating Cycle 2 Health Deficiency Score: 80
Rating Cycle 2 Number of Health Revisits: 1
Rating Cycle 2 Health Revisit Score: 0
Rating Cycle 2 Total Health Score: 80
Total Weighted Health Survey Score: 63.200
Number of Facility Reported Incidents: 12
Number of Fines: 1
Total Amount of Fines in Dollars: 27400
Number of Payment Denials: 0
Total Number of Penalties: 1
Processing Date: 2018-04-01