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PACIFIC HAVEN SUBACUTE AND HEALTHCARE CENTER

Overall Rating

Address

12072 Trask Ave.

Garden Grove, CA 92843

Contact

7145341942

Certification Date

1980-01-01

Details

CMS Certification Number

055575

Ownership Type

For profit - Corporation

Number of Certified Beds

99

Average Number of Residents per Day

91.6

Provider Type

Medicare and Medicaid

Legal Business Name

12072 TRASK, INC.

Affiliated Entity Name

Affiliated Entity ID

Ratings

Health Inspection Rating

4

Quality Measure Rating

5

Staffing Rating

4

Staffing

Reported Nurse Aide Staffing Hours per Resident per Day

3.18422

Reported LPN Staffing Hours per Resident per Day

2.44520

Reported RN Staffing Hours per Resident per Day

0.86153

Reported Total Nurse Staffing Hours per Resident per Day

6.49095

Total Number of Nurse Staff Hours per Resident per Day on the Weekend

6.13863

Registered Nurse Hours per Resident per Day on the Weekend

0.68692

Reported Physical Therapist Staffing Hours per Resident Per Day

0.05357

Quality Measures

Long-Stay Quality Measure Rating

5

Short-Stay Quality Measure Rating

5

Inspections

Total Weighted Health Survey Score

53.333

Number of Facility Reported Incidents

0

Number of Substantiated Complaints

3

Number of Citations from Infection Control Inspections

0

Health Inspections

Rating Cycle 1

Standard Health Survey Date

2022-11-23

Total Number of Health Deficiencies

10

Number of Standard Health Deficiencies

6

Number of Complaint Health Deficiencies

4

Health Deficiency Score

44

Number of Health Revisits

1

Health Revisit Score

0

Total Health Score

44

Rating Cycle 2

Standard Health Survey Date

2019-04-17

Total Number of Health Deficiencies

15

Number of Standard Health Deficiencies

15

Number of Complaint Health Deficiencies

0

Health Deficiency Score

60

Number of Health Revisits

1

Health Revisit Score

0

Total Health Score

60

Rating Cycle 3

Standard Health Survey Date

2018-05-02

Total Number of Health Deficiencies

17

Number of Standard Health Deficiencies

17

Number of Complaint Health Deficiencies

0

Health Deficiency Score

68

Number of Health Revisits

1

Health Revisit Score

0

Total Health Score

68

Penalties

Number of Fines

0

Total Amount of Fines in Dollars

0.00

Number of Payment Denials

0

Total Number of Penalties

0