020000111 |
JONES CONVALESCENT HOSPITAL |
LTC |
SNF |
Skilled Nursing Facility |
East Bay |
2006-12-06 00:00:00 |
020003546 |
Closed |
Citation |
Citation A (HSC 1424) |
Patient Care |
None |
2006-08-03 00:00:00 |
2006-08-03 00:00:00 |
No |
2006-12-28 00:00:00 |
None |
A |
None |
16000 |
16000 |
-5600 |
10400 |
0 |
None |
49ZL11 |
N |
CA00090772 |
C |
SFY2006-07 |
100000999 |
JEAN MARTIN HOME #3 |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
Sacramento |
2013-02-22 00:00:00 |
030009751 |
Closed |
Citation |
Citation B (HSC 1424) |
Abuse/Facility Not Self Reported |
None |
2009-09-03 00:00:00 |
2009-09-03 00:00:00 |
No |
2013-03-15 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
None |
LBQI11 |
N |
CA00200718 |
A |
SFY2012-13 |
100001800 |
J & M'S ICF/DDH HOME |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
Stockton |
2019-02-27 00:00:00 |
030014829 |
Closed |
Citation |
Citation B (HSC 1424) |
Abuse/Facility Not Self Reported |
None |
2018-12-04 00:00:00 |
2018-12-04 00:00:00 |
No |
2019-03-20 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
None |
589E11 |
N |
CA00614617, CA00616110, CA00616110 |
A, B, B |
SFY2018-19 |
100000911 |
JEAN MARTIN HOME #2 |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
Sacramento |
2024-06-17 00:00:00 |
030020303 |
Closed |
Citation |
Citation B (HSC 1424) |
Abuse/Facility Not Self Reported |
None |
2024-01-03 00:00:00 |
2024-01-03 00:00:00 |
No |
2024-07-09 00:00:00 |
None |
B |
None |
3000 |
3000 |
-1050 |
1950 |
0 |
None |
TNC511 |
N |
CA00898947 |
B |
SFY2023-24 |
040000345 |
JOHN C. FREMONT HEALTHCARE DISTRICT D/P SNF |
LTC |
SNF |
Skilled Nursing Facility |
Fresno |
2001-12-06 00:00:00 |
040001233 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2001-08-05 00:00:00 |
2001-08-05 00:00:00 |
No |
2002-01-04 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
040012377 |
A99999 |
N |
None |
None |
SFY2001-02 |
040000345 |
JOHN C. FREMONT HEALTHCARE DISTRICT D/P SNF |
LTC |
SNF |
Skilled Nursing Facility |
Fresno |
2002-09-13 00:00:00 |
040001267 |
Closed |
Citation |
Citation A (HSC 1424) |
Medication |
None |
2001-10-24 00:00:00 |
2001-10-24 00:00:00 |
No |
2002-10-07 00:00:00 |
None |
A |
None |
2000 |
2000 |
-700 |
1300 |
0 |
040013697 |
A99999 |
N |
None |
None |
SFY2002-03 |
050001098 |
JADE HOME |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
Ventura |
2000-02-18 00:00:00 |
050001365 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2000-01-06 00:00:00 |
2000-01-06 00:00:00 |
No |
2000-03-30 00:00:00 |
None |
B |
None |
700 |
700 |
-245 |
455 |
0 |
050013548 |
A99999 |
N |
None |
None |
SFY1999-00 |
050001098 |
JADE HOME |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
Ventura |
2003-09-09 00:00:00 |
050001587 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Rights |
None |
2003-08-04 00:00:00 |
None |
No |
2003-10-02 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
050016825 |
A99999 |
N |
None |
None |
SFY2003-04 |
050000898 |
JESSICA HOUSE |
LTC |
ICFDDN |
Intermediate Care Facility-DD/H/N/CN/IID |
Ventura |
2005-01-21 00:00:00 |
050001623 |
Closed |
Citation |
Citation B (HSC 1424) |
Abuse/Facility Not Self Reported |
None |
2004-11-14 00:00:00 |
None |
No |
2005-02-11 00:00:00 |
None |
B |
None |
100 |
100 |
0 |
100 |
0 |
050017769 |
A99999 |
N |
None |
None |
SFY2004-05 |
050000929 |
JOANNE COMMUNITY HOME |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
Ventura |
2005-09-22 00:00:00 |
050001634 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Rights |
None |
2005-08-16 00:00:00 |
2005-08-16 00:00:00 |
No |
2005-10-18 00:00:00 |
None |
B |
None |
200 |
200 |
0 |
200 |
0 |
050017816 |
A99999 |
N |
None |
None |
SFY2005-06 |
050001098 |
JADE HOME |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
Ventura |
2008-04-16 00:00:00 |
050004792 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Rights |
None |
2008-03-06 00:00:00 |
2008-03-06 00:00:00 |
No |
2008-05-07 00:00:00 |
None |
B |
None |
400 |
400 |
-140 |
260 |
0 |
None |
7Q1X11 |
N |
CA00141860 |
B |
SFY2007-08 |
050001098 |
JADE HOME |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
Ventura |
2013-12-04 00:00:00 |
050009092 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Rights |
None |
2010-11-08 00:00:00 |
2010-11-08 00:00:00 |
No |
2013-12-26 00:00:00 |
None |
B |
None |
500 |
500 |
-175 |
325 |
0 |
None |
5X2M11 |
N |
CA00248775, CA00248817 |
E, E |
SFY2013-14 |
050001098 |
JADE HOME |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
Ventura |
2017-02-03 00:00:00 |
050012858 |
Closed |
Citation |
Citation B (HSC 1424) |
Abuse/Facility Not Self Reported |
Abuse/Facility Not Self R |
2016-08-15 00:00:00 |
2016-08-15 00:00:00 |
No |
2017-02-27 00:00:00 |
None |
B |
None |
855 |
855 |
-299.25 |
555.75 |
0 |
None |
0FN611 |
N |
CA00504689, CA00505004 |
A, A |
SFY2016-17 |
060000780 |
JOHN DOUGLAS FRENCH CENTER FOR ALZHEIMER'S DISEASE |
LTC |
SNF |
Skilled Nursing Facility |
Orange |
2001-07-12 00:00:00 |
060001064 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Rights |
None |
1999-03-01 00:00:00 |
None |
Yes |
2001-10-25 00:00:00 |
2001-10-09 00:00:00 |
B |
B |
800 |
800 |
0 |
800 |
0 |
060010848 |
A99999 |
N |
None |
None |
SFY2001-02 |
060001025 |
JENYMEL'S HOME |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
Orange |
2002-03-11 00:00:00 |
060001090 |
Closed |
Citation |
Citation B (HSC 1424) |
Other |
SAFEGUARDS CLIENT MO |
2002-02-08 00:00:00 |
None |
No |
2002-04-02 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
060011556 |
A99999 |
N |
None |
None |
SFY2001-02 |
060001990 |
J AND P HOMES - SAN PEDRO |
LTC |
ICFDDN |
Intermediate Care Facility-DD/H/N/CN/IID |
Orange |
2002-10-15 00:00:00 |
060001118 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2002-07-26 00:00:00 |
None |
No |
2002-11-05 00:00:00 |
None |
B |
None |
500 |
500 |
-175 |
325 |
0 |
060012520 |
A99999 |
N |
None |
None |
SFY2002-03 |
090000076 |
JACOB HEALTHCARE CENTER |
LTC |
SNF |
Skilled Nursing Facility |
San Diego |
2000-12-15 00:00:00 |
090002762 |
Closed |
Citation |
Citation B (HSC 1424) |
Other |
PATIENT TRUST ACCNT. |
2000-08-29 00:00:00 |
None |
No |
2001-01-10 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
090022371 |
A99999 |
N |
None |
None |
SFY2000-01 |
090000076 |
JACOB HEALTHCARE CENTER |
LTC |
SNF |
Skilled Nursing Facility |
San Diego |
2001-08-30 00:00:00 |
090002776 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2001-07-17 00:00:00 |
2001-07-17 00:00:00 |
No |
2001-10-10 00:00:00 |
None |
B |
None |
700 |
700 |
-245 |
455 |
0 |
090023166 |
A99999 |
N |
None |
None |
SFY2001-02 |
090000114 |
JACK CLOSE HOUSE |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
San Diego |
2002-10-17 00:00:00 |
090002817 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2002-09-11 00:00:00 |
None |
No |
2002-11-07 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
090024490 |
A99999 |
N |
None |
None |
SFY2002-03 |
090000076 |
JACOB HEALTHCARE CENTER |
LTC |
SNF |
Skilled Nursing Facility |
San Diego |
2002-11-19 00:00:00 |
090002821 |
Closed |
Citation |
Citation B (HSC 1424) |
Problem Transfer |
None |
2002-09-28 00:00:00 |
2002-09-28 00:00:00 |
Yes |
2002-12-10 00:00:00 |
2002-12-10 00:00:00 |
B |
B |
250 |
950 |
0 |
950 |
0 |
090024530 |
A99999 |
N |
None |
None |
SFY2002-03 |
110000621 |
JEROLD PHELPS COMMUNITY HOSPITAL D/P SNF |
LTC |
SNF |
Skilled Nursing Facility |
Santa Rosa |
2009-01-05 00:00:00 |
110005488 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2008-09-30 00:00:00 |
2008-09-30 00:00:00 |
No |
2009-01-27 00:00:00 |
None |
B |
None |
900 |
900 |
-315 |
585 |
0 |
None |
5R2D11 |
N |
CA00164776 |
A |
SFY2008-09 |
110000621 |
JEROLD PHELPS COMMUNITY HOSPITAL D/P SNF |
LTC |
SNF |
Skilled Nursing Facility |
Santa Rosa |
2015-10-22 00:00:00 |
110011473 |
Closed |
Citation |
Citation A (HSC 1424) |
Patient Care |
None |
2014-12-06 00:00:00 |
2014-12-06 00:00:00 |
No |
2015-11-13 00:00:00 |
None |
A |
None |
20000 |
20000 |
-7000 |
13000 |
0 |
None |
GOIW11 |
N |
CA00425299 |
B |
SFY2015-16 |
110000621 |
JEROLD PHELPS COMMUNITY HOSPITAL D/P SNF |
LTC |
SNF |
Skilled Nursing Facility |
Santa Rosa |
2016-01-20 00:00:00 |
110011925 |
Closed |
Citation |
Citation B (HSC 1424) |
Abuse/Facility Not Self Reported |
None |
2014-11-09 00:00:00 |
2014-11-09 00:00:00 |
No |
2016-02-10 00:00:00 |
None |
B |
None |
2000 |
2000 |
-700 |
1300 |
0 |
None |
C8TE11 |
N |
CA00420246 |
B |
SFY2015-16 |
110000621 |
JEROLD PHELPS COMMUNITY HOSPITAL D/P SNF |
LTC |
SNF |
Skilled Nursing Facility |
Santa Rosa |
2017-11-01 00:00:00 |
110012138 |
Open |
Citation |
Citation A (HSC 1424) |
Patient Care |
None |
2015-06-06 00:00:00 |
2015-06-06 00:00:00 |
No |
2017-11-27 00:00:00 |
None |
A |
None |
20000 |
20000 |
-7000 |
13000 |
0 |
None |
U56W11 |
N |
CA00448194 |
B |
SFY2017-18 |
120001566 |
JAN & GAIL'S CARE HOME 4 |
LTC |
ICFDDN |
Intermediate Care Facility-DD/H/N/CN/IID |
Bakersfield |
2004-04-16 00:00:00 |
120001779 |
Closed |
Citation |
Citation B (HSC 1424) |
Administration |
None |
2004-01-19 00:00:00 |
None |
No |
2004-05-25 00:00:00 |
None |
B |
None |
300 |
300 |
-105 |
195 |
0 |
120020486 |
A99999 |
N |
None |
None |
SFY2003-04 |
220000933 |
JAMES COURT MANOR INC. |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
San Francisco |
2000-06-13 00:00:00 |
220001048 |
Closed |
Citation |
Citation B (HSC 1424) |
Physical Environment |
None |
2000-04-27 00:00:00 |
None |
No |
2000-07-05 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
220006974 |
A99999 |
N |
None |
None |
SFY1999-00 |
220000518 |
JEWISH HOME & REHAB CENTER D/P SNF |
LTC |
SNF |
Skilled Nursing Facility |
San Francisco |
2002-03-27 00:00:00 |
220001510 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Rights |
None |
2000-11-20 00:00:00 |
None |
No |
2002-04-18 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
220011046 |
A99999 |
N |
None |
None |
SFY2001-02 |
220000518 |
JEWISH HOME & REHAB CENTER D/P SNF |
LTC |
SNF |
Skilled Nursing Facility |
San Francisco |
2002-07-18 00:00:00 |
220001522 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Rights |
None |
2002-03-14 00:00:00 |
None |
No |
2002-08-08 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
220011030 |
A99999 |
N |
None |
None |
SFY2002-03 |
220000518 |
JEWISH HOME & REHAB CENTER D/P SNF |
LTC |
SNF |
Skilled Nursing Facility |
San Francisco |
2006-04-28 00:00:00 |
220003068 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Rights |
None |
2005-04-22 00:00:00 |
2005-04-22 00:00:00 |
No |
2006-05-19 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
None |
8WIN11 |
N |
CA00045571 |
C |
SFY2005-06 |
220000518 |
JEWISH HOME & REHAB CENTER D/P SNF |
LTC |
SNF |
Skilled Nursing Facility |
San Francisco |
2007-05-09 00:00:00 |
220003936 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Rights |
None |
2007-03-07 00:00:00 |
2007-03-07 00:00:00 |
Yes |
2007-05-30 00:00:00 |
2007-05-24 00:00:00 |
B |
B |
1000 |
500 |
0 |
500 |
0 |
None |
V2Y911 |
N |
CA00108494 |
B |
SFY2006-07 |
220000518 |
JEWISH HOME & REHAB CENTER D/P SNF |
LTC |
SNF |
Skilled Nursing Facility |
San Francisco |
2007-05-09 00:00:00 |
220003942 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Rights |
None |
2007-02-25 00:00:00 |
2007-02-25 00:00:00 |
Yes |
2007-05-30 00:00:00 |
2007-05-24 00:00:00 |
B |
B |
1000 |
500 |
0 |
500 |
0 |
None |
F6J611 |
N |
CA00108093 |
B |
SFY2006-07 |
220000518 |
JEWISH HOME & REHAB CENTER D/P SNF |
LTC |
SNF |
Skilled Nursing Facility |
San Francisco |
2007-05-09 00:00:00 |
220003947 |
Closed |
Citation |
Citation B (HSC 1424) |
Abuse/Facility Not Self Reported |
None |
2007-02-25 00:00:00 |
2007-02-25 00:00:00 |
Yes |
2007-05-31 00:00:00 |
2007-05-24 00:00:00 |
B |
None |
1000 |
1000 |
0 |
1000 |
0 |
None |
F6J611 |
N |
CA00108093 |
B |
SFY2006-07 |
220000518 |
JEWISH HOME & REHAB CENTER D/P SNF |
LTC |
SNF |
Skilled Nursing Facility |
San Francisco |
2008-05-01 00:00:00 |
220004974 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Rights |
None |
2008-03-04 00:00:00 |
2008-03-04 00:00:00 |
Yes |
2008-05-22 00:00:00 |
2008-05-01 00:00:00 |
B |
B |
1000 |
500 |
0 |
500 |
0 |
None |
HQ6111 |
N |
CA00142766 |
C |
SFY2007-08 |
630006441 |
JTM HOME |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
San Francisco |
2008-12-01 00:00:00 |
220005640 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2008-05-29 00:00:00 |
2008-05-29 00:00:00 |
No |
2008-12-22 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
None |
U3RI11 |
N |
CA00152452 |
B |
SFY2008-09 |
220000518 |
JEWISH HOME & REHAB CENTER D/P SNF |
LTC |
SNF |
Skilled Nursing Facility |
San Francisco |
2020-02-10 00:00:00 |
220015732 |
Closed |
Citation |
Citation A (HSC 1424) |
Patient Care |
None |
2018-12-16 00:00:00 |
2018-12-16 00:00:00 |
Yes |
2020-03-02 00:00:00 |
2020-02-11 00:00:00 |
A |
B |
20000 |
12000 |
0 |
12000 |
0 |
None |
0C2V11 |
N |
CA00616191, CA00616499 |
B, B |
SFY2019-20 |
220000518 |
JEWISH HOME & REHAB CENTER D/P SNF |
LTC |
SNF |
Skilled Nursing Facility |
San Francisco |
2022-08-29 00:00:00 |
220017940 |
Open |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2022-02-18 00:00:00 |
2022-02-18 00:00:00 |
Yes |
2022-09-20 00:00:00 |
2022-09-09 00:00:00 |
B |
None |
2000 |
2000 |
0 |
0 |
2000 |
None |
V71M11 |
N |
CA00774239 |
C |
SFY2022-23 |
240000252 |
JOSHUA TREE POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
San Bernardino |
2001-04-24 00:00:00 |
240001668 |
Closed |
Citation |
Citation B (HSC 1424) |
Administration |
None |
2001-03-22 00:00:00 |
None |
No |
2001-06-14 00:00:00 |
None |
B |
None |
1000 |
1000 |
-1000 |
0 |
0 |
240014176 |
A99999 |
N |
None |
None |
SFY2000-01 |
240000252 |
JOSHUA TREE POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
San Bernardino |
2001-04-24 00:00:00 |
240001672 |
Closed |
Citation |
Citation B (HSC 1424) |
Administration |
None |
2001-02-08 00:00:00 |
None |
No |
2001-06-14 00:00:00 |
None |
B |
None |
1000 |
1000 |
-1000 |
0 |
0 |
240014031 |
A99999 |
N |
None |
None |
SFY2000-01 |
240000252 |
JOSHUA TREE POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
San Bernardino |
2001-04-25 00:00:00 |
240001673 |
Closed |
Citation |
Citation A (HSC 1424) |
Physical Environment |
None |
2001-03-14 00:00:00 |
2001-03-14 00:00:00 |
No |
2001-05-16 00:00:00 |
None |
A |
None |
18000 |
18000 |
-18000 |
0 |
0 |
240014031 |
A99999 |
N |
None |
None |
SFY2000-01 |
240000252 |
JOSHUA TREE POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
San Bernardino |
2002-03-22 00:00:00 |
240001710 |
Closed |
Citation |
Citation A (HSC 1424) |
Patient Care |
None |
2001-10-24 00:00:00 |
2001-10-24 00:00:00 |
Yes |
2002-04-12 00:00:00 |
2002-03-22 00:00:00 |
A |
None |
8000 |
8000 |
-8000 |
0 |
0 |
240015490 |
A99999 |
N |
None |
None |
SFY2001-02 |
240000126 |
JANE HOUSE |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
San Bernardino |
2004-04-29 00:00:00 |
240001803 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2002-11-04 00:00:00 |
2002-11-04 00:00:00 |
No |
2004-05-20 00:00:00 |
None |
B |
None |
400 |
400 |
0 |
400 |
0 |
240016849 |
A99999 |
N |
None |
None |
SFY2003-04 |
240000252 |
JOSHUA TREE POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
San Bernardino |
2006-05-09 00:00:00 |
240003082 |
Closed |
Citation |
Citation B (HSC 1424) |
Dietary |
None |
2005-11-03 00:00:00 |
2005-11-03 00:00:00 |
No |
2006-05-31 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
None |
K5T111 |
N |
CA00061187 |
C |
SFY2005-06 |
240000252 |
JOSHUA TREE POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
San Bernardino |
2006-05-09 00:00:00 |
240003083 |
Closed |
Citation |
Citation B (HSC 1424) |
Administration |
None |
2005-11-17 00:00:00 |
2005-11-17 00:00:00 |
No |
2006-05-31 00:00:00 |
None |
B |
None |
1000 |
1900 |
-350 |
1550 |
0 |
None |
BJVN11 |
N |
CA00056257 |
C |
SFY2005-06 |
240000126 |
JANE HOUSE |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
San Bernardino |
2006-07-10 00:00:00 |
240003197 |
Closed |
Citation |
Citation A (HSC 1424) |
Patient Rights |
None |
2005-06-17 00:00:00 |
2005-06-17 00:00:00 |
Yes |
2006-07-31 00:00:00 |
2006-07-14 00:00:00 |
A |
B |
10000 |
2500 |
0 |
2500 |
0 |
None |
RFCV11 |
N |
CA00052377 |
C |
SFY2006-07 |
240001842 |
JASPER DIVISION |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
San Bernardino |
2007-01-24 00:00:00 |
240003659 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2006-05-10 00:00:00 |
2006-05-10 00:00:00 |
No |
2007-02-15 00:00:00 |
None |
B |
None |
1000 |
1000 |
0 |
1000 |
0 |
None |
S2HD11 |
N |
CA00080490 |
C |
SFY2006-07 |
240001842 |
JASPER DIVISION |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
San Bernardino |
2011-03-02 00:00:00 |
240007977 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2010-11-10 00:00:00 |
2010-11-10 00:00:00 |
No |
2011-03-23 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
None |
6ND311 |
N |
CA00249371 |
B |
SFY2010-11 |
240000252 |
JOSHUA TREE POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
San Bernardino |
2012-04-12 00:00:00 |
240009227 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2010-12-12 00:00:00 |
2010-12-12 00:00:00 |
No |
2012-05-03 00:00:00 |
None |
B |
None |
1000 |
1000 |
0 |
1000 |
0 |
None |
DKBW11 |
N |
CA00252271 |
B |
SFY2011-12 |
240000252 |
JOSHUA TREE POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
San Bernardino |
2016-06-15 00:00:00 |
240012330 |
Closed |
Citation |
Citation A (HSC 1424) |
Patient Care |
None |
2014-08-02 00:00:00 |
2014-08-02 00:00:00 |
No |
2016-07-07 00:00:00 |
None |
A |
None |
17000 |
17000 |
-5950 |
11050 |
0 |
None |
KKKY11 |
N |
CA00408651 |
B |
SFY2015-16 |
240000252 |
JOSHUA TREE POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
San Bernardino |
2016-11-10 00:00:00 |
240012742 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Rights |
None |
2016-09-30 00:00:00 |
2016-09-30 00:00:00 |
No |
2016-12-06 00:00:00 |
None |
B |
None |
2000 |
2000 |
0 |
2000 |
0 |
None |
3JLG11 |
N |
None |
None |
SFY2016-17 |
240000252 |
JOSHUA TREE POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
San Bernardino |
2018-09-21 00:00:00 |
240014403 |
Closed |
Citation |
Citation A (HSC 1424) |
Patient Care |
None |
2018-05-01 00:00:00 |
2018-05-01 00:00:00 |
No |
2018-10-12 00:00:00 |
None |
A |
None |
20000 |
20000 |
-7000 |
13000 |
0 |
None |
T7X111 |
Y |
CA00585851 |
A |
SFY2018-19 |
240000252 |
JOSHUA TREE POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
San Bernardino |
2023-11-20 00:00:00 |
240019385 |
Open |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2023-10-03 00:00:00 |
2023-10-03 00:00:00 |
No |
2023-12-13 00:00:00 |
None |
B |
None |
3000 |
3000 |
0 |
3000 |
0 |
None |
WD6Y11 |
N |
CA00862527, CA00863706, CA00863706, CA00863706 |
B, A, A, A |
SFY2023-24 |
250000694 |
JOEL'S HOUSE |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
Riverside |
2002-11-14 00:00:00 |
250001505 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2002-06-06 00:00:00 |
None |
No |
2002-12-18 00:00:00 |
None |
B |
None |
500 |
500 |
-175 |
325 |
0 |
250013841 |
A99999 |
N |
None |
None |
SFY2002-03 |
250001441 |
JUAN BAUTISTA |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
Riverside |
2008-03-07 00:00:00 |
250004765 |
Closed |
Citation |
Citation B (HSC 1424) |
Abuse/Facility Not Self Reported |
None |
2007-12-11 00:00:00 |
2007-12-11 00:00:00 |
No |
2008-03-28 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
None |
1MQI11 |
N |
CA00134614 |
B |
SFY2007-08 |
630007321 |
JACK SURNOW HOUSE |
LTC |
CLHF |
Congregate Living Health Facility |
Riverside |
2008-09-03 00:00:00 |
250005382 |
Closed |
Citation |
Citation B (HSC 1424) |
Other |
AB-Abuse |
2007-09-17 00:00:00 |
2007-09-17 00:00:00 |
Yes |
2008-09-24 00:00:00 |
2008-09-11 00:00:00 |
B |
B |
1000 |
500 |
0 |
500 |
0 |
None |
DKOK11 |
N |
CA00126832 |
C |
SFY2008-09 |
250000087 |
JURUPA HILLS POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
Riverside |
2016-01-06 00:00:00 |
250011835 |
Closed |
Citation |
Citation B (HSC 1424) |
Abuse/Facility Not Self Reported |
None |
2015-04-03 00:00:00 |
2015-04-03 00:00:00 |
No |
2016-01-28 00:00:00 |
None |
B |
None |
2000 |
2000 |
-700 |
1300 |
0 |
None |
3YTK11 |
N |
CA00437663, CA00458277, CA00467160, CA00467162 |
C, C, C, C |
SFY2015-16 |
250000087 |
JURUPA HILLS POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
Riverside |
2016-01-20 00:00:00 |
250011968 |
Closed |
Citation |
Citation B (HSC 1424) |
Abuse/Facility Not Self Reported |
None |
2015-09-09 00:00:00 |
2015-09-09 00:00:00 |
Yes |
2016-02-10 00:00:00 |
2016-02-05 00:00:00 |
B |
Drop>Deficiency |
2000 |
500 |
0 |
500 |
0 |
None |
IIQW11 |
N |
CA00457763 |
B |
SFY2015-16 |
250000087 |
JURUPA HILLS POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
Riverside |
2016-01-20 00:00:00 |
250011969 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2014-07-01 00:00:00 |
2014-07-01 00:00:00 |
Yes |
2016-02-10 00:00:00 |
2016-02-10 00:00:00 |
B |
B |
2000 |
1250 |
0 |
1250 |
0 |
None |
SR9211 |
N |
CA00431076 |
B |
SFY2015-16 |
250000087 |
JURUPA HILLS POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
Riverside |
2016-04-07 00:00:00 |
250012161 |
Closed |
Citation |
Citation B (HSC 1424) |
Other |
Free of Accident Hazards |
2015-09-06 00:00:00 |
2015-09-06 00:00:00 |
Yes |
2016-04-28 00:00:00 |
2016-04-18 00:00:00 |
B |
B |
1000 |
1000 |
0 |
1000 |
0 |
None |
WK1211 |
N |
CA00458277, CA00459935 |
C, C |
SFY2015-16 |
250000087 |
JURUPA HILLS POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
Riverside |
2016-04-19 00:00:00 |
250012202 |
Closed |
Citation |
Citation B (HSC 1424) |
Abuse/Facility Not Self Reported |
None |
2015-12-07 00:00:00 |
2015-12-07 00:00:00 |
Yes |
2016-05-10 00:00:00 |
2016-04-19 00:00:00 |
B |
B |
1000 |
1000 |
0 |
1000 |
0 |
None |
OHLX11 |
N |
CA00469110 |
B |
SFY2015-16 |
250000087 |
JURUPA HILLS POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
Riverside |
2017-02-09 00:00:00 |
250012948 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2015-10-19 00:00:00 |
2015-10-19 00:00:00 |
No |
2017-03-03 00:00:00 |
None |
B |
None |
2000 |
2350 |
-700 |
1650 |
0 |
None |
4MGS11 |
N |
CA00463217 |
C |
SFY2016-17 |
250000087 |
JURUPA HILLS POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
Riverside |
2017-03-07 00:00:00 |
250013007 |
Closed |
Citation |
Citation B (HSC 1424) |
Abuse/Facility Not Self Reported |
None |
2017-01-10 00:00:00 |
2017-01-10 00:00:00 |
No |
2017-03-28 00:00:00 |
None |
B |
None |
2000 |
2000 |
-700 |
1300 |
0 |
None |
D5VF11 |
N |
None |
None |
SFY2016-17 |
630012729 |
JACKIE LEE AND JIM HOUSTON HOUSE |
LTC |
ICFDDN |
Intermediate Care Facility-DD/H/N/CN/IID |
Riverside |
2017-12-21 00:00:00 |
250013676 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2017-03-10 00:00:00 |
2017-03-10 00:00:00 |
No |
2018-01-12 00:00:00 |
None |
B |
None |
2000 |
2000 |
-700 |
1300 |
0 |
None |
09JH11 |
N |
CA00526377 |
B |
SFY2017-18 |
250000087 |
JURUPA HILLS POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
Riverside |
2018-02-28 00:00:00 |
250013853 |
Closed |
Citation |
Citation B (HSC 1424) |
Other |
Unusual Occurence/Not Rep |
2017-10-28 00:00:00 |
2017-10-28 00:00:00 |
No |
2018-03-21 00:00:00 |
None |
B |
None |
2000 |
2000 |
-700 |
1300 |
0 |
None |
2JX911 |
Y |
CA00557509 |
B |
SFY2017-18 |
630007321 |
JACK SURNOW HOUSE |
LTC |
CLHF |
Congregate Living Health Facility |
Riverside |
2018-06-07 00:00:00 |
250014091 |
Closed |
Citation |
Citation B (HSC 1424) |
Abuse/Facility Not Self Reported |
None |
2017-06-05 00:00:00 |
2017-06-05 00:00:00 |
No |
2018-06-28 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
None |
K2LO11 |
N |
CA00538216 |
B |
SFY2017-18 |
250000087 |
JURUPA HILLS POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
Riverside |
2018-08-16 00:00:00 |
250014187 |
Closed |
Citation |
Citation B (HSC 1424) |
Other |
Accidents |
2018-05-15 00:00:00 |
2018-05-15 00:00:00 |
No |
2018-09-07 00:00:00 |
None |
B |
None |
2000 |
2000 |
0 |
2000 |
0 |
None |
5GC811 |
N |
None |
None |
SFY2018-19 |
250000087 |
JURUPA HILLS POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
Riverside |
2018-08-06 00:00:00 |
250014275 |
Closed |
Citation |
Citation B (HSC 1424) |
Abuse/Facility Not Self Reported |
None |
2018-02-10 00:00:00 |
2018-02-10 00:00:00 |
No |
2018-08-27 00:00:00 |
None |
B |
None |
2000 |
2000 |
0 |
2000 |
0 |
None |
YY7N11 |
N |
CA00573592 |
B |
SFY2018-19 |
250000087 |
JURUPA HILLS POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
Riverside |
2019-03-20 00:00:00 |
250014869 |
Closed |
Citation |
Citation B (HSC 1424) |
Abuse/Facility Not Self Reported |
None |
2018-10-21 00:00:00 |
2018-10-21 00:00:00 |
No |
2019-04-10 00:00:00 |
None |
B |
None |
2000 |
6000 |
0 |
6000 |
0 |
None |
IIG111 |
N |
CA00612872, CA00612872 |
B, B |
SFY2018-19 |
250000087 |
JURUPA HILLS POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
Riverside |
2019-07-25 00:00:00 |
250015185 |
Closed |
Citation |
Citation B (HSC 1424) |
Abuse/Facility Not Self Reported |
None |
2019-05-11 00:00:00 |
2019-05-11 00:00:00 |
No |
2019-08-15 00:00:00 |
None |
B |
None |
2000 |
6000 |
-2100 |
3900 |
0 |
None |
V9TI11 |
N |
CA00637811 |
B |
SFY2019-20 |
630011499 |
JOYCE EISENBERG KEEFER MEDICAL CENTER |
LTC |
SNF |
Skilled Nursing Facility |
LA Region 2 |
2019-09-11 00:00:00 |
920015387 |
Closed |
Citation |
Citation A (HSC 1424) |
Patient Care |
None |
2019-06-27 00:00:00 |
2019-06-27 00:00:00 |
No |
2019-10-02 00:00:00 |
None |
A |
None |
15000 |
15000 |
-5250 |
9750 |
0 |
None |
494Q11 |
N |
CA00644443 |
B |
SFY2019-20 |
630011499 |
JOYCE EISENBERG KEEFER MEDICAL CENTER |
LTC |
SNF |
Skilled Nursing Facility |
LA Region 2 |
2009-08-03 00:00:00 |
930006409 |
Closed |
Citation |
Citation A (HSC 1424) |
Patient Care |
None |
2009-02-26 00:00:00 |
2009-02-26 00:00:00 |
Yes |
2009-08-24 00:00:00 |
2009-08-14 00:00:00 |
A |
None |
5000 |
5000 |
0 |
5000 |
0 |
None |
58NZ11 |
N |
CA00181216 |
C |
SFY2009-10 |
630011499 |
JOYCE EISENBERG KEEFER MEDICAL CENTER |
LTC |
SNF |
Skilled Nursing Facility |
LA Region 2 |
2011-03-31 00:00:00 |
930008037 |
Closed |
Citation |
Citation Willful Material Falsification (HSC 1424(f)(1)) |
Patient Record |
None |
2010-10-27 00:00:00 |
2010-10-27 00:00:00 |
No |
2011-04-21 00:00:00 |
None |
WF |
None |
2000 |
2000 |
0 |
2000 |
0 |
None |
TV4411 |
None |
None |
None |
SFY2010-11 |
630011499 |
JOYCE EISENBERG KEEFER MEDICAL CENTER |
LTC |
SNF |
Skilled Nursing Facility |
LA Region 2 |
2012-07-03 00:00:00 |
930009378 |
Closed |
Citation |
Citation A (HSC 1424) |
Patient Care |
None |
2011-09-11 00:00:00 |
2011-09-11 00:00:00 |
Yes |
2012-07-25 00:00:00 |
2012-07-13 00:00:00 |
A |
B |
15000 |
15000 |
0 |
15000 |
0 |
None |
ZOV311 |
N |
CA00283490 |
B |
SFY2012-13 |
630011499 |
JOYCE EISENBERG KEEFER MEDICAL CENTER |
LTC |
SNF |
Skilled Nursing Facility |
LA Region 2 |
2015-10-16 00:00:00 |
930011726 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Rights |
None |
2015-07-22 00:00:00 |
2015-07-22 00:00:00 |
No |
2015-11-06 00:00:00 |
None |
B |
None |
2000 |
2000 |
0 |
2000 |
0 |
None |
OTWT11 |
N |
CA00451837 |
B |
SFY2015-16 |
630011499 |
JOYCE EISENBERG KEEFER MEDICAL CENTER |
LTC |
SNF |
Skilled Nursing Facility |
LA Region 2 |
2019-03-29 00:00:00 |
930014928 |
Closed |
Citation |
Citation A (HSC 1424) |
Patient Care |
None |
2018-10-10 00:00:00 |
2018-10-10 00:00:00 |
Yes |
2019-04-22 00:00:00 |
2019-04-10 00:00:00 |
A |
B |
20000 |
1000 |
0 |
1000 |
0 |
None |
NB7I11 |
N |
None |
None |
SFY2018-19 |
630011499 |
JOYCE EISENBERG KEEFER MEDICAL CENTER |
LTC |
SNF |
Skilled Nursing Facility |
LA Region 2 |
2019-03-29 00:00:00 |
930014929 |
Closed |
Citation |
Citation A (HSC 1424) |
Patient Care |
None |
2018-09-18 00:00:00 |
2018-09-18 00:00:00 |
Yes |
2019-04-19 00:00:00 |
2019-04-10 00:00:00 |
A |
A |
20000 |
3100 |
-100 |
3000 |
0 |
None |
NB7I11 |
N |
None |
None |
SFY2018-19 |
960001871 |
JO-MI ALTA 5 |
LTC |
ICFDDN |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2000-12-12 00:00:00 |
960000880 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2000-10-23 00:00:00 |
None |
Yes |
2001-05-30 00:00:00 |
2000-12-28 00:00:00 |
B |
B |
600 |
600 |
0 |
600 |
0 |
960007438 |
A99999 |
N |
None |
None |
SFY2000-01 |
960002036 |
JENYMEL'S HOME CARE INC. III |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2001-03-07 00:00:00 |
960000888 |
Closed |
Citation |
Citation B (HSC 1424) |
Other |
ACTIVE TREATMENT |
2001-01-29 00:00:00 |
None |
No |
2001-05-18 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
960007563 |
A99999 |
N |
None |
None |
SFY2000-01 |
960002036 |
JENYMEL'S HOME CARE INC. III |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2001-12-07 00:00:00 |
960000944 |
Closed |
Citation |
Citation B (HSC 1424) |
Staffing |
None |
2001-11-26 00:00:00 |
None |
No |
2001-12-31 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
960008197 |
A99999 |
N |
None |
None |
SFY2001-02 |
960001896 |
JANRAY |
LTC |
ICFDDN |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2002-11-04 00:00:00 |
960000992 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Rights |
None |
2002-09-26 00:00:00 |
None |
No |
2002-12-04 00:00:00 |
None |
B |
None |
600 |
600 |
-210 |
390 |
0 |
960008824 |
A99999 |
N |
None |
None |
SFY2002-03 |
960002705 |
JADE RANCH |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2003-02-10 00:00:00 |
960001004 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Rights |
None |
2003-01-30 00:00:00 |
None |
Yes |
2003-05-27 00:00:00 |
2003-05-14 00:00:00 |
B |
B |
1000 |
1000 |
0 |
1000 |
0 |
960009004 |
A99999 |
N |
None |
None |
SFY2002-03 |
960001584 |
JOYCE MARIE HOMES INC |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2003-03-12 00:00:00 |
960001009 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Rights |
None |
2003-02-12 00:00:00 |
None |
No |
2003-04-10 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
960009047 |
A99999 |
N |
None |
None |
SFY2002-03 |
960001584 |
JOYCE MARIE HOMES INC |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2003-03-20 00:00:00 |
960001010 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Rights |
None |
2003-02-11 00:00:00 |
None |
No |
2003-04-18 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
960009068 |
A99999 |
N |
None |
None |
SFY2002-03 |
960002204 |
J-J EXCELCARE HOME 2 |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2003-04-29 00:00:00 |
960001015 |
Closed |
Citation |
Citation B (HSC 1424) |
Administration |
None |
2003-03-28 00:00:00 |
None |
No |
2003-05-28 00:00:00 |
None |
B |
None |
800 |
800 |
-280 |
520 |
0 |
960009131 |
A99999 |
N |
None |
None |
SFY2002-03 |
960001255 |
JO-MI INTERMEDIATE CARE FAC/DEVELOPMENTALLY-NRSG |
LTC |
ICFDDN |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2004-07-23 00:00:00 |
960001083 |
Closed |
Citation |
Citation B (HSC 1424) |
Administration |
None |
2004-06-07 00:00:00 |
None |
No |
2004-09-17 00:00:00 |
None |
B |
None |
800 |
800 |
-280 |
520 |
0 |
960009773 |
A99999 |
N |
None |
None |
SFY2004-05 |
960002036 |
JENYMEL'S HOME CARE INC. III |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2004-08-18 00:00:00 |
960001089 |
Closed |
Citation |
Citation B (HSC 1424) |
Administration |
None |
2004-08-06 00:00:00 |
None |
No |
2004-11-05 00:00:00 |
None |
B |
None |
900 |
900 |
-315 |
585 |
0 |
960009856 |
A99999 |
N |
None |
None |
SFY2004-05 |
960000929 |
JULIAN HOUSE |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2005-06-08 00:00:00 |
960001121 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2005-04-04 00:00:00 |
None |
No |
2005-06-29 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
960010139 |
A99999 |
N |
None |
None |
SFY2004-05 |
960002705 |
JADE RANCH |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2005-12-13 00:00:00 |
960001160 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Rights |
None |
2005-10-12 00:00:00 |
None |
Yes |
2006-01-05 00:00:00 |
2005-12-28 00:00:00 |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
960010366 |
A99999 |
N |
None |
None |
SFY2005-06 |
960002705 |
JADE RANCH |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2005-12-13 00:00:00 |
960001161 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Rights |
None |
2005-10-19 00:00:00 |
None |
No |
2006-01-26 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
960010366 |
A99999 |
N |
None |
None |
SFY2005-06 |
960000929 |
JULIAN HOUSE |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2006-06-14 00:00:00 |
960003160 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2005-06-02 00:00:00 |
2005-06-02 00:00:00 |
Yes |
2006-07-21 00:00:00 |
2006-06-15 00:00:00 |
B |
B |
1000 |
500 |
0 |
500 |
0 |
None |
OTXO11 |
N |
None |
None |
SFY2005-06 |
960000929 |
JULIAN HOUSE |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2006-06-15 00:00:00 |
960003167 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2006-05-06 00:00:00 |
2006-05-06 00:00:00 |
Yes |
2006-07-21 00:00:00 |
2006-06-15 00:00:00 |
B |
B |
1000 |
500 |
0 |
500 |
0 |
None |
OTXO11 |
N |
None |
None |
SFY2005-06 |
960001584 |
JOYCE MARIE HOMES INC |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2007-04-13 00:00:00 |
960003900 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2007-03-20 00:00:00 |
2007-03-20 00:00:00 |
No |
2007-05-04 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
None |
FW6H11 |
N |
None |
None |
SFY2006-07 |
960001584 |
JOYCE MARIE HOMES INC |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2007-04-13 00:00:00 |
960003901 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Rights |
None |
2007-03-17 00:00:00 |
2007-03-17 00:00:00 |
No |
2007-05-04 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
None |
FW6H11 |
N |
None |
None |
SFY2006-07 |
960000929 |
JULIAN HOUSE |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2007-10-04 00:00:00 |
960004320 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2007-02-03 00:00:00 |
2007-02-03 00:00:00 |
No |
2007-10-26 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
None |
B82111 |
Y |
CA00107812 |
C |
SFY2007-08 |
630004921 |
JANRAY HOME II |
LTC |
ICFDDN |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2008-10-27 00:00:00 |
960005550 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2008-09-11 00:00:00 |
2008-09-11 00:00:00 |
No |
2008-11-18 00:00:00 |
None |
B |
None |
1000 |
1000 |
0 |
1000 |
0 |
None |
ZDQD11 |
N |
None |
None |
SFY2008-09 |
630004921 |
JANRAY HOME II |
LTC |
ICFDDN |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2008-10-27 00:00:00 |
960005551 |
Closed |
Citation |
Citation B (HSC 1424) |
Administration |
None |
2008-09-11 00:00:00 |
2008-09-11 00:00:00 |
No |
2008-11-18 00:00:00 |
None |
B |
None |
1000 |
1000 |
0 |
1000 |
0 |
None |
ZDQD11 |
N |
None |
None |
SFY2008-09 |
960001255 |
JO-MI INTERMEDIATE CARE FAC/DEVELOPMENTALLY-NRSG |
LTC |
ICFDDN |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2008-12-04 00:00:00 |
960005666 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2008-10-10 00:00:00 |
2008-10-10 00:00:00 |
Yes |
2008-12-26 00:00:00 |
2008-12-26 00:00:00 |
B |
B |
1000 |
650 |
0 |
650 |
0 |
None |
JTZQ11 |
N |
None |
None |
SFY2008-09 |
630004921 |
JANRAY HOME II |
LTC |
ICFDDN |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2010-01-05 00:00:00 |
960006869 |
Closed |
Citation |
Citation B (HSC 1424) |
Financial Occurrence/Fac Not Self Reported |
None |
2009-11-19 00:00:00 |
2009-11-19 00:00:00 |
No |
2010-01-28 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
None |
EFK011 |
N |
None |
None |
SFY2009-10 |
960002036 |
JENYMEL'S HOME CARE INC. III |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2011-05-18 00:00:00 |
960008157 |
Closed |
Citation |
Citation AA (HSC 1424) |
Dietary |
None |
2010-07-29 00:00:00 |
2010-07-29 00:00:00 |
No |
2011-06-09 00:00:00 |
None |
AA |
None |
20000 |
20000 |
-7000 |
13000 |
0 |
None |
ITYX11 |
Y |
CA00237721 |
C |
SFY2010-11 |
960001896 |
JANRAY |
LTC |
ICFDDN |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2014-12-05 00:00:00 |
960011153 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Rights |
None |
2014-03-08 00:00:00 |
2014-03-08 00:00:00 |
No |
2014-12-29 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
None |
EJ6L11 |
N |
None |
None |
SFY2014-15 |
960002705 |
JADE RANCH |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2017-03-31 00:00:00 |
960013102 |
Closed |
Citation |
Citation B (HSC 1424) |
Patient Care |
None |
2017-01-28 00:00:00 |
2017-01-28 00:00:00 |
No |
2017-04-21 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
None |
REYY11 |
N |
CA00520411 |
C |
SFY2016-17 |
630004921 |
JANRAY HOME II |
LTC |
ICFDDN |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2017-06-20 00:00:00 |
960013259 |
Closed |
Citation |
Citation A (HSC 1424) |
Patient Care |
None |
2017-02-04 00:00:00 |
2017-02-04 00:00:00 |
No |
2017-07-12 00:00:00 |
None |
A |
None |
5000 |
5000 |
-1750 |
3250 |
0 |
None |
CXFS11 |
Y |
CA00521228 |
B |
SFY2016-17 |
960002204 |
J-J EXCELCARE HOME 2 |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2020-02-12 00:00:00 |
960015733 |
Closed |
Citation |
Citation B (HSC 1424) |
Abuse/Facility Not Self Reported |
None |
2019-06-19 00:00:00 |
2019-06-19 00:00:00 |
No |
2020-03-04 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
None |
YCGM11 |
N |
CA00642932 |
B |
SFY2019-20 |
960001723 |
JENYMEL'S HOME CARE, INC. II |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
LA ICF/DD/Clinics |
2020-10-16 00:00:00 |
960016095 |
Closed |
Citation |
Citation B (HSC 1424) |
Abuse/Facility Not Self Reported |
None |
2020-07-23 00:00:00 |
2020-07-23 00:00:00 |
No |
2020-11-06 00:00:00 |
None |
B |
None |
1000 |
1000 |
-350 |
650 |
0 |
None |
8JLP11 |
N |
CA00698255, CA00698321 |
A, A |
SFY2020-21 |
100001800 |
J & M'S ICF/DDH HOME |
LTC |
ICFDDH |
Intermediate Care Facility-DD/H/N/CN/IID |
Stockton |
2024-05-03 00:00:00 |
990020091 |
Closed |
Citation |
Citation B (HSC 1424) |
Abuse/Facility Not Self Reported |
None |
2023-09-08 00:00:00 |
2023-09-08 00:00:00 |
No |
2024-05-24 00:00:00 |
None |
B |
None |
3000 |
3000 |
-1050 |
1950 |
0 |
None |
LCEK11 |
N |
CA00886160 |
B |
SFY2023-24 |
240000252 |
JOSHUA TREE POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
San Bernardino |
2020-11-09 00:00:00 |
030016107 |
Closed |
Administrative Penalty |
AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5) |
DHPPD: 12 - 24 Days |
None |
2019-03-04 00:00:00 |
2019-06-03 00:00:00 |
No |
2020-11-24 00:00:00 |
None |
AP NHPPD |
None |
30000 |
30000 |
0 |
30000 |
0 |
None |
KVWD11 |
None |
None |
None |
SFY2020-21 |
240000252 |
JOSHUA TREE POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
San Bernardino |
2014-09-11 00:00:00 |
240010983 |
Closed |
Administrative Penalty |
AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5) |
DHPPD: 2 - 11 Days |
None |
2014-03-09 00:00:00 |
2014-06-08 00:00:00 |
Yes |
2014-09-26 00:00:00 |
None |
AP NHPPD |
UPHELD |
15000 |
15000 |
0 |
15000 |
0 |
None |
CUUR11 |
None |
None |
None |
SFY2014-15 |
240000252 |
JOSHUA TREE POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
San Bernardino |
2018-08-28 00:00:00 |
240014350 |
Closed |
Administrative Penalty |
AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5) |
DHPPD: 2 - 11 Days |
None |
2017-03-17 00:00:00 |
2017-06-16 00:00:00 |
No |
2018-09-12 00:00:00 |
None |
AP NHPPD |
None |
15000 |
15000 |
0 |
15000 |
0 |
None |
UCFL11 |
None |
None |
None |
SFY2018-19 |
240000252 |
JOSHUA TREE POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
San Bernardino |
2021-10-14 00:00:00 |
810016991 |
Closed |
Administrative Penalty |
AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5) |
DHPPD: 12 - 24 Days |
None |
2019-10-01 00:00:00 |
2019-12-31 00:00:00 |
No |
2021-10-29 00:00:00 |
None |
AP NHPPD |
None |
30000 |
30000 |
0 |
30000 |
0 |
None |
SI5Y11 |
None |
None |
None |
SFY2021-22 |
250000087 |
JURUPA HILLS POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
Riverside |
2022-03-21 00:00:00 |
810017489 |
Closed |
Administrative Penalty |
AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5) |
DHPPD: 2 - 11 Days |
None |
2019-07-01 00:00:00 |
2019-09-30 00:00:00 |
No |
2022-04-05 00:00:00 |
None |
AP NHPPD |
None |
15000 |
15000 |
0 |
15000 |
0 |
None |
ZHTG11 |
None |
None |
None |
SFY2021-22 |
240000252 |
JOSHUA TREE POST ACUTE |
LTC |
SNF |
Skilled Nursing Facility |
San Bernardino |
2024-05-06 00:00:00 |
810020077 |
Open |
Administrative Penalty |
AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5) |
DHPPD: 12 - 24 Days |
None |
2020-10-01 00:00:00 |
2020-12-31 00:00:00 |
No |
2024-05-28 00:00:00 |
None |
AP NHPPD |
None |
50000 |
50000 |
0 |
0 |
50000 |
None |
15RC11 |
None |
None |
None |
SFY2023-24 |
140000196 |
JOHN MUIR MEDICAL CENTER-CONCORD CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2008-02-20 00:00:00 |
020004706 |
Closed |
Failure to Report Penalty |
Failure to Report Adverse Events to CDPH (HSC 1280.4) |
AE17 - Stage 3 or 4 ulcer acquired after admission |
None |
2007-11-02 12:26:00 |
2007-11-02 12:26:00 |
Yes |
2008-03-14 00:00:00 |
2008-02-28 00:00:00 |
FTR AE |
None |
2800 |
2800 |
0 |
2800 |
0 |
None |
F3F211 |
N |
CA00135308 |
C |
SFY2007-08 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2008-02-25 00:00:00 |
020004711 |
Closed |
Failure to Report Penalty |
Failure to Report Adverse Events to CDPH (HSC 1280.4) |
AE17 - Stage 3 or 4 ulcer acquired after admission |
None |
2008-01-31 14:30:00 |
2008-01-31 14:30:00 |
Yes |
2008-04-02 00:00:00 |
2008-03-03 00:00:00 |
FTR AE |
None |
700 |
700 |
0 |
700 |
0 |
None |
1YMD11 |
N |
CA00140955 |
C |
SFY2007-08 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2008-03-13 00:00:00 |
020004785 |
Closed |
Failure to Report Penalty |
Failure to Report Adverse Events to CDPH (HSC 1280.4) |
AE17 - Stage 3 or 4 ulcer acquired after admission |
None |
2008-01-16 12:27:00 |
2008-01-16 12:27:00 |
Yes |
2008-04-07 00:00:00 |
2008-03-19 00:00:00 |
FTR AE |
None |
700 |
700 |
0 |
700 |
0 |
None |
DM3Z11 |
N |
CA00139055 |
C |
SFY2007-08 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2008-06-20 00:00:00 |
020005148 |
Closed |
Failure to Report Penalty |
Failure to Report Adverse Events to CDPH (HSC 1280.4) |
AE04 - Retention of a foreign object in a patient |
None |
2008-04-26 04:40:00 |
2008-04-26 04:40:00 |
No |
2008-07-16 00:00:00 |
None |
FTR AE |
None |
800 |
800 |
0 |
800 |
0 |
None |
NRTW11 |
N |
CA00150159 |
B |
SFY2007-08 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2008-07-01 00:00:00 |
020005183 |
Closed |
Failure to Report Penalty |
Failure to Report Adverse Events to CDPH (HSC 1280.4) |
AE28 - Adverse event or series of adverse events |
None |
2008-04-02 18:23:00 |
2008-04-02 18:23:00 |
No |
2008-07-23 00:00:00 |
None |
FTR AE |
None |
1400 |
1400 |
0 |
1400 |
0 |
None |
124K11 |
N |
CA00147721 |
B |
SFY2008-09 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2008-07-03 00:00:00 |
020005188 |
Closed |
Failure to Report Penalty |
Failure to Report Adverse Events to CDPH (HSC 1280.4) |
AE17 - Stage 3 or 4 ulcer acquired after admission |
None |
2008-06-06 08:15:00 |
2008-06-06 08:15:00 |
No |
2008-07-25 00:00:00 |
None |
FTR AE |
None |
700 |
700 |
0 |
700 |
0 |
None |
Z1QT11 |
N |
CA00154662 |
C |
SFY2008-09 |
140000196 |
JOHN MUIR MEDICAL CENTER-CONCORD CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2008-08-27 00:00:00 |
020005338 |
Closed |
Failure to Report Penalty |
Failure to Report Adverse Events to CDPH (HSC 1280.4) |
AE17 - Stage 3 or 4 ulcer acquired after admission |
None |
2008-06-30 09:45:00 |
2008-06-30 09:45:00 |
No |
2008-09-19 00:00:00 |
None |
FTR AE |
None |
400 |
400 |
0 |
400 |
0 |
None |
77KV11 |
N |
CA00156194 |
C |
SFY2008-09 |
140000196 |
JOHN MUIR MEDICAL CENTER-CONCORD CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2008-10-21 00:00:00 |
020005525 |
Closed |
Failure to Report Penalty |
Failure to Report Adverse Events to CDPH (HSC 1280.4) |
AE17 - Stage 3 or 4 ulcer acquired after admission |
None |
2008-09-03 16:00:00 |
2008-09-03 16:00:00 |
No |
2008-11-13 00:00:00 |
None |
FTR AE |
None |
300 |
300 |
0 |
300 |
0 |
None |
Y86F11 |
N |
None |
None |
SFY2008-09 |
140000196 |
JOHN MUIR MEDICAL CENTER-CONCORD CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2008-12-08 00:00:00 |
020005673 |
Closed |
Administrative Penalty |
AP - Immediate Jeopardy (HSC 1280.3) |
AE28 - Adverse event or series of adverse events |
State Monitoring |
2008-10-18 00:00:00 |
2008-10-18 00:00:00 |
No |
2008-12-30 00:00:00 |
None |
AP IJ |
None |
25000 |
25000 |
0 |
25000 |
0 |
None |
RMYI11 |
N |
CA00167372 |
B |
SFY2008-09 |
140000196 |
JOHN MUIR MEDICAL CENTER-CONCORD CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2009-07-03 00:00:00 |
020006347 |
Closed |
Failure to Report Penalty |
Failure to Report Adverse Events to CDPH (HSC 1280.4) |
AE17 - Stage 3 or 4 ulcer acquired after admission |
None |
2009-04-11 11:00:00 |
2009-04-11 11:00:00 |
No |
2009-07-24 00:00:00 |
None |
FTR AE |
None |
700 |
700 |
0 |
700 |
0 |
None |
56EH11 |
N |
CA00186064 |
C |
SFY2009-10 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2010-02-16 00:00:00 |
020006917 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to CDPH (HSC 1280.15(b)(1)) |
Breach by h/c worker within facility/hc system |
None |
2009-06-22 15:00:00 |
2009-06-22 15:00:00 |
No |
2010-03-11 00:00:00 |
None |
FTR BR |
None |
500 |
500 |
-125 |
375 |
0 |
None |
1IT611 |
None |
CA00195652 |
D |
SFY2009-10 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2010-02-16 00:00:00 |
020006959 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to CDPH (HSC 1280.15(b)(1)) |
Deliberate breach by person other than a h/c worker |
None |
2009-02-23 15:00:00 |
2009-02-23 15:00:00 |
No |
2010-03-11 00:00:00 |
None |
FTR BR |
None |
500 |
500 |
-125 |
375 |
0 |
None |
1IT611 |
None |
CA00195652 |
D |
SFY2009-10 |
140000832 |
JOHN MUIR BEHAVIORAL HEALTH CENTER |
Non-LTC |
APH |
Acute Psychiatric Hospital |
East Bay |
2010-04-20 00:00:00 |
020007102 |
Closed |
Administrative Penalty |
AP - Immediate Jeopardy (HSC 1280.3) |
AE11 - Suicide/attempted suicide |
None |
2010-01-18 00:00:00 |
2010-01-18 00:00:00 |
No |
2010-05-11 00:00:00 |
None |
AP IJ |
AP IJ |
50000 |
30000 |
0 |
30000 |
0 |
None |
CF3811 |
Y |
CA00215949 |
B |
SFY2009-10 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2010-04-22 00:00:00 |
020007103 |
Closed |
Administrative Penalty |
AP - Immediate Jeopardy (HSC 1280.3) |
AE11 - Suicide/attempted suicide |
None |
2010-02-23 00:00:00 |
2010-02-23 00:00:00 |
No |
2010-12-29 00:00:00 |
None |
AP IJ |
AP IJ |
50000 |
30000 |
0 |
30000 |
0 |
None |
ISZN11 |
N |
CA00219946 |
B |
SFY2009-10 |
140000196 |
JOHN MUIR MEDICAL CENTER-CONCORD CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2010-05-25 00:00:00 |
020007228 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to CDPH (HSC 1280.15(b)(1)) |
Breach by h/c worker within facility/hc system |
None |
2009-11-12 12:00:00 |
2009-11-12 12:00:00 |
No |
2010-06-16 00:00:00 |
None |
FTR BR |
None |
2300 |
2300 |
-575 |
1725 |
0 |
None |
ZUSM11 |
None |
CA00211672 |
D |
SFY2009-10 |
140000196 |
JOHN MUIR MEDICAL CENTER-CONCORD CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2010-06-14 00:00:00 |
020007296 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to Resident (HSC 1280.15(b)(2)) |
Breach to person/entity outside facility/hc system |
None |
2009-07-24 15:00:00 |
2009-07-24 15:00:00 |
No |
2010-07-07 00:00:00 |
None |
FTR RES |
None |
1000 |
1000 |
-250 |
750 |
0 |
None |
XMU611 |
None |
CA00199293 |
D |
SFY2009-10 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2010-07-30 00:00:00 |
020007426 |
Closed |
Administrative Penalty |
AP - Breach (HSC 1280.15) |
Breach to person/entity outside facility/hc system |
None |
2009-06-15 00:00:00 |
2009-06-15 00:00:00 |
No |
2012-10-01 00:00:00 |
None |
AP BR |
None |
42500 |
42500 |
-10625 |
31875 |
0 |
None |
YR3L11 |
None |
CA00200378 |
C |
SFY2010-11 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2010-09-13 00:00:00 |
020007553 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to CDPH (HSC 1280.15(b)(1)) |
Breach to person/entity outside facility/hc system |
None |
2010-08-13 00:00:00 |
2010-08-13 00:00:00 |
No |
2010-10-04 00:00:00 |
None |
FTR BR |
None |
200 |
200 |
-50 |
150 |
0 |
None |
TKK611 |
None |
CA00201329 |
D |
SFY2010-11 |
020000161 |
JOHN MUIR HOME HEALTH SERVICES |
Non-LTC |
HHA |
Home Health Agency |
East Bay |
2011-01-11 00:00:00 |
020007825 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to CDPH (HSC 1280.15(b)(1)) |
Breach by h/c worker within facility/hc system |
None |
2010-07-19 00:00:00 |
2010-07-19 00:00:00 |
No |
2011-02-02 00:00:00 |
None |
FTR BR |
None |
800 |
800 |
-200 |
600 |
0 |
None |
G9Y311 |
None |
CA00239446 |
C |
SFY2010-11 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2011-02-17 00:00:00 |
020007950 |
Closed |
Failure to Report Penalty |
Failure to Report Adverse Events to CDPH (HSC 1280.4) |
AE17 - Stage 3 or 4 ulcer acquired after admission |
None |
2011-01-01 13:25:00 |
2011-01-01 13:25:00 |
No |
2011-03-11 00:00:00 |
None |
FTR AE |
None |
500 |
500 |
0 |
500 |
0 |
None |
2LCJ11 |
N |
CA00255262 |
C |
SFY2010-11 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2011-03-01 00:00:00 |
020007953 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to CDPH (HSC 1280.15(b)(1)) |
Breach to person/entity outside facility/hc system |
None |
2009-10-18 00:00:00 |
2009-10-18 00:00:00 |
No |
2011-03-22 00:00:00 |
None |
FTR BR |
None |
8000 |
8000 |
-2000 |
6000 |
0 |
None |
VLGS11 |
None |
CA00220364 |
D |
SFY2010-11 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2011-03-01 00:00:00 |
020007954 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to Resident (HSC 1280.15(b)(2)) |
Breach to person/entity outside facility/hc system |
None |
2009-10-18 00:00:00 |
2009-10-18 00:00:00 |
No |
2011-03-22 00:00:00 |
None |
FTR RES |
None |
8000 |
8000 |
-8000 |
0 |
0 |
None |
VLGS11 |
None |
CA00220364 |
D |
SFY2010-11 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2011-05-05 00:00:00 |
020008214 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to CDPH (HSC 1280.15(b)(1)) |
Breach to person/entity outside facility/hc system |
None |
2009-11-21 12:39:00 |
2009-11-21 12:39:00 |
No |
2011-05-26 00:00:00 |
None |
FTR BR |
None |
2300 |
2300 |
-575 |
1725 |
0 |
None |
RSMP11 |
None |
CA00213566 |
D |
SFY2010-11 |
140000196 |
JOHN MUIR MEDICAL CENTER-CONCORD CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2011-08-01 00:00:00 |
020008427 |
Closed |
Failure to Report Penalty |
Failure to Report Adverse Events to CDPH (HSC 1280.4) |
AE17 - Stage 3 or 4 ulcer acquired after admission |
None |
2011-04-03 16:15:00 |
2011-04-03 16:15:00 |
No |
2011-08-22 00:00:00 |
None |
FTR AE |
None |
500 |
500 |
0 |
500 |
0 |
None |
BOMZ11 |
N |
CA00266175 |
C |
SFY2011-12 |
140000196 |
JOHN MUIR MEDICAL CENTER-CONCORD CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2011-08-30 00:00:00 |
020008518 |
Closed |
Failure to Report Penalty |
Failure to Report Adverse Events to CDPH (HSC 1280.4) |
AE22 - Death associated with a fall |
None |
2011-04-10 07:05:00 |
2011-04-10 07:05:00 |
No |
2011-09-21 00:00:00 |
None |
FTR AE |
None |
2000 |
2000 |
0 |
2000 |
0 |
None |
5D0Y11 |
Y |
CA00270377 |
B |
SFY2011-12 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2011-10-26 00:00:00 |
020008677 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to CDPH (HSC 1280.15(b)(1)) |
Breach to person/entity outside facility/hc system |
None |
2009-10-30 12:00:00 |
2009-10-30 12:00:00 |
No |
2011-11-17 00:00:00 |
None |
FTR BR |
None |
13200 |
13200 |
-3300 |
9900 |
0 |
None |
73GM11 |
None |
CA00222169 |
D |
SFY2011-12 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2011-10-26 00:00:00 |
020008679 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to Resident (HSC 1280.15(b)(2)) |
Breach to person/entity outside facility/hc system |
None |
2009-10-30 12:00:00 |
2009-10-30 12:00:00 |
No |
2011-11-17 00:00:00 |
None |
FTR RES |
None |
13000 |
13000 |
-3250 |
9750 |
0 |
None |
73GM11 |
None |
CA00222169 |
D |
SFY2011-12 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2012-03-06 00:00:00 |
020009075 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to CDPH (HSC 1280.15(b)(1)) |
Breach to person/entity outside facility/hc system |
None |
2010-04-17 17:00:00 |
2010-04-17 17:00:00 |
No |
2012-03-27 00:00:00 |
None |
FTR BR |
None |
300 |
300 |
-75 |
225 |
0 |
None |
I02F11 |
None |
CA00230595 |
D |
SFY2011-12 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2012-03-06 00:00:00 |
020009076 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to Resident (HSC 1280.15(b)(2)) |
Breach to person/entity outside facility/hc system |
None |
2010-04-17 17:00:00 |
2010-04-17 17:00:00 |
No |
2012-03-27 00:00:00 |
None |
FTR RES |
None |
300 |
300 |
-75 |
225 |
0 |
None |
I02F11 |
None |
CA00230595 |
D |
SFY2011-12 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2012-04-27 00:00:00 |
020009225 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to Resident (HSC 1280.15(b)(2)) |
Breach to person/entity outside facility/hc system |
None |
2010-01-17 13:04:00 |
2010-01-17 13:04:00 |
No |
2012-05-18 00:00:00 |
None |
FTR RES |
None |
13100 |
13100 |
-3275 |
9825 |
0 |
None |
IHKY11 |
None |
CA00235336 |
D |
SFY2011-12 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2012-04-27 00:00:00 |
020009226 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to CDPH (HSC 1280.15(b)(1)) |
Breach to person/entity outside facility/hc system |
None |
2010-01-17 13:04:00 |
2010-01-17 13:04:00 |
No |
2012-05-18 00:00:00 |
None |
FTR BR |
None |
13100 |
13100 |
-3275 |
9825 |
0 |
None |
IHKY11 |
None |
CA00235336 |
D |
SFY2011-12 |
140000196 |
JOHN MUIR MEDICAL CENTER-CONCORD CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2012-05-07 00:00:00 |
020009280 |
Closed |
Failure to Report Penalty |
Failure to Report Adverse Events to CDPH (HSC 1280.4) |
AE08 - Death/disability due to intravascular air embolism |
None |
2011-10-31 11:32:00 |
2011-10-31 11:32:00 |
No |
2012-05-29 00:00:00 |
None |
FTR AE |
None |
11500 |
11500 |
0 |
11500 |
0 |
None |
QGL711 |
Y |
CA00303523 |
B |
SFY2011-12 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2013-02-28 00:00:00 |
020009758 |
Closed |
Failure to Report Penalty |
Failure to Report Adverse Events to CDPH (HSC 1280.4) |
AE03 - Wrong surgical procedure performed on a patient |
None |
2012-10-25 08:49:00 |
2012-10-25 08:49:00 |
No |
2013-03-21 00:00:00 |
None |
FTR AE |
None |
500 |
500 |
0 |
500 |
0 |
None |
WJZ011 |
N |
CA00333374 |
C |
SFY2012-13 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2013-05-01 00:00:00 |
020009843 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to CDPH (HSC 1280.15(b)(1)) |
Patient Rights |
None |
2013-01-18 09:00:00 |
2013-01-18 09:00:00 |
No |
2013-05-22 00:00:00 |
None |
FTR BR |
None |
400 |
400 |
-100 |
300 |
0 |
None |
MG8G11 |
None |
CA00340435 |
C |
SFY2012-13 |
140000196 |
JOHN MUIR MEDICAL CENTER-CONCORD CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2017-09-08 00:00:00 |
020013191 |
Closed |
Administrative Penalty |
AP - Non-Immediate Jeopardy (HSC 1280.3) |
Other Non-Immediate Jeopardy (not an AE) |
None |
2015-11-09 00:00:00 |
2015-11-09 00:00:00 |
No |
2017-09-29 00:00:00 |
None |
AP NON-IJ |
None |
12720 |
12720 |
0 |
12720 |
0 |
None |
ZT9E11 |
Y |
CA00468168 |
C |
SFY2017-18 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2018-06-15 00:00:00 |
020014153 |
Closed |
Administrative Penalty |
AP - Non-Immediate Jeopardy (HSC 1280.3) |
Other Non-Immediate Jeopardy (not an AE) |
None |
2015-03-05 00:00:00 |
2015-03-05 00:00:00 |
No |
2018-07-09 00:00:00 |
None |
AP NON-IJ |
None |
5775 |
5775 |
0 |
5775 |
0 |
None |
MLTC11 |
Y |
CA00519013 |
B |
SFY2017-18 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2018-10-10 00:00:00 |
020014539 |
Closed |
Administrative Penalty |
AP - Breach (HSC 1280.15) |
Deliberate breach of PHI by health care worker |
None |
2014-11-17 00:00:00 |
2014-11-17 00:00:00 |
No |
2019-04-12 00:00:00 |
None |
AP BR |
None |
49500 |
49500 |
-12375 |
37125 |
0 |
None |
LJ2Y11 |
None |
CA00547171, CA00547171 |
C, C |
SFY2018-19 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2018-11-08 00:00:00 |
020014690 |
Closed |
Administrative Penalty |
AP - Breach (HSC 1280.15) |
Deliberate breach of PHI by health care worker |
None |
2015-10-30 00:00:00 |
2015-10-30 00:00:00 |
No |
2018-12-04 00:00:00 |
None |
AP BR |
None |
0 |
0 |
0 |
0 |
0 |
None |
95GG11 |
None |
CA00491933 |
D |
SFY2018-19 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2022-01-28 00:00:00 |
020017261 |
Closed |
Administrative Penalty |
AP - Breach (HSC 1280.15) |
Deliberate breach by person other than a h/c worker |
None |
2013-09-10 00:00:00 |
2013-09-10 00:00:00 |
No |
2022-02-22 00:00:00 |
None |
AP BR |
None |
15000 |
15000 |
-3750 |
11250 |
0 |
None |
WIZ211 |
None |
CA00374060 |
D |
SFY2021-22 |
140000187 |
JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS |
Non-LTC |
GACH |
General Acute Care Hospital |
East Bay |
2021-12-03 00:00:00 |
020017900 |
Closed |
Administrative Penalty |
AP - Breach (HSC 1280.15) |
Deliberate breach of PHI by health care worker |
None |
2017-04-01 00:00:00 |
2017-04-01 00:00:00 |
No |
2022-09-15 00:00:00 |
None |
AP BR |
None |
30000 |
30000 |
-7500 |
22500 |
0 |
None |
4H3J11 |
None |
CA00596331 |
D |
SFY2021-22 |
110000057 |
JEROLD PHELPS COMMUNITY HOSPITAL |
Non-LTC |
GACH |
General Acute Care Hospital |
Santa Rosa |
2014-06-25 00:00:00 |
110009857 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to CDPH (HSC 1280.15(b)(1)) |
Breach to person/entity outside facility/hc system |
None |
2012-06-26 11:25:00 |
2012-06-26 11:25:00 |
No |
2014-07-17 00:00:00 |
None |
FTR BR |
None |
700 |
700 |
-175 |
525 |
0 |
None |
SOJN11 |
None |
CA00317815 |
C |
SFY2013-14 |
110000057 |
JEROLD PHELPS COMMUNITY HOSPITAL |
Non-LTC |
GACH |
General Acute Care Hospital |
Santa Rosa |
2014-06-25 00:00:00 |
110009858 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to Resident (HSC 1280.15(b)(2)) |
Breach to person/entity outside facility/hc system |
None |
2012-06-26 11:25:00 |
2012-06-26 11:25:00 |
No |
2014-07-17 00:00:00 |
None |
FTR RES |
None |
700 |
700 |
-175 |
525 |
0 |
None |
SOJN11 |
None |
CA00317815 |
C |
SFY2013-14 |
250000017 |
JOHN F. KENNEDY MEMORIAL HOSPITAL |
Non-LTC |
GACH |
General Acute Care Hospital |
Riverside |
2009-09-16 00:00:00 |
250006559 |
Closed |
Administrative Penalty |
AP - Immediate Jeopardy (HSC 1280.3) |
AE28 - Adverse event or series of adverse events |
None |
2008-08-04 00:00:00 |
2008-08-04 00:00:00 |
Yes |
2009-10-07 00:00:00 |
2010-01-28 00:00:00 |
AP IJ |
AP IJ |
25000 |
17500 |
0 |
17500 |
0 |
None |
96D811 |
N |
CA00158812, CA00158976 |
B, C |
SFY2009-10 |
250000017 |
JOHN F. KENNEDY MEMORIAL HOSPITAL |
Non-LTC |
GACH |
General Acute Care Hospital |
Riverside |
2009-09-16 00:00:00 |
250006564 |
Closed |
Administrative Penalty |
AP - Immediate Jeopardy (HSC 1280.3) |
AE12 - Medication error |
None |
2008-08-04 00:00:00 |
2008-08-04 00:00:00 |
Yes |
2009-10-07 00:00:00 |
2010-01-28 00:00:00 |
AP IJ |
AP IJ |
25000 |
17500 |
0 |
17500 |
0 |
None |
96D811 |
N |
CA00158812, CA00159980 |
B, C |
SFY2009-10 |
250000017 |
JOHN F. KENNEDY MEMORIAL HOSPITAL |
Non-LTC |
GACH |
General Acute Care Hospital |
Riverside |
2009-09-16 00:00:00 |
250006565 |
Closed |
Administrative Penalty |
AP - Immediate Jeopardy (HSC 1280.3) |
AE12 - Medication error |
None |
2008-08-04 00:00:00 |
2008-08-04 00:00:00 |
Yes |
2009-10-07 00:00:00 |
2010-01-28 00:00:00 |
AP IJ |
AP IJ |
25000 |
17500 |
0 |
17500 |
0 |
None |
96D811 |
N |
CA00158812 |
B |
SFY2009-10 |
250000017 |
JOHN F. KENNEDY MEMORIAL HOSPITAL |
Non-LTC |
GACH |
General Acute Care Hospital |
Riverside |
2009-09-16 00:00:00 |
250006566 |
Closed |
Administrative Penalty |
AP - Immediate Jeopardy (HSC 1280.3) |
AE28 - Adverse event or series of adverse events |
None |
2008-08-04 00:00:00 |
2008-08-04 00:00:00 |
Yes |
2009-10-07 00:00:00 |
2010-01-28 00:00:00 |
AP IJ |
AP IJ |
25000 |
17500 |
0 |
17500 |
0 |
None |
96D811 |
N |
CA00158812 |
B |
SFY2009-10 |
250000017 |
JOHN F. KENNEDY MEMORIAL HOSPITAL |
Non-LTC |
GACH |
General Acute Care Hospital |
Riverside |
2010-07-20 00:00:00 |
250007412 |
Closed |
Failure to Report Penalty |
Failure to Report Adverse Events to CDPH (HSC 1280.4) |
AE28 - Adverse event or series of adverse events |
None |
2008-11-03 00:00:00 |
2008-11-03 00:00:00 |
No |
2010-08-10 00:00:00 |
None |
FTR AE |
None |
3200 |
3200 |
0 |
3200 |
0 |
None |
N27711 |
N |
CA00171903 |
C |
SFY2010-11 |
250000017 |
JOHN F. KENNEDY MEMORIAL HOSPITAL |
Non-LTC |
GACH |
General Acute Care Hospital |
Riverside |
2011-05-18 00:00:00 |
250008263 |
Closed |
Failure to Report Penalty |
Failure to Report Adverse Events to CDPH (HSC 1280.4) |
AE28 - Adverse event or series of adverse events |
None |
2009-10-07 00:00:00 |
2009-10-07 00:00:00 |
No |
2011-06-09 00:00:00 |
None |
FTR AE |
None |
100 |
100 |
0 |
100 |
0 |
None |
RBQI11 |
N |
CA00204865 |
C |
SFY2010-11 |
250000017 |
JOHN F. KENNEDY MEMORIAL HOSPITAL |
Non-LTC |
GACH |
General Acute Care Hospital |
Riverside |
2012-02-13 00:00:00 |
250009015 |
Closed |
Administrative Penalty |
AP - Immediate Jeopardy (HSC 1280.3) |
AE01 - Surgery performed on a wrong body part |
None |
2010-10-29 00:00:00 |
2010-10-29 00:00:00 |
Yes |
2012-09-20 00:00:00 |
2012-09-04 00:00:00 |
AP IJ |
AP IJ |
50000 |
35000 |
0 |
35000 |
0 |
None |
X0XG11 |
N |
CA00247960 |
C |
SFY2011-12 |
250000017 |
JOHN F. KENNEDY MEMORIAL HOSPITAL |
Non-LTC |
GACH |
General Acute Care Hospital |
Riverside |
2014-02-05 00:00:00 |
250010444 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to Resident (HSC 1280.15(b)(2)) |
Breach by h/c worker within facility/hc system |
None |
2012-10-15 00:00:00 |
2012-10-15 00:00:00 |
No |
2014-02-27 00:00:00 |
None |
FTR RES |
None |
900 |
900 |
0 |
900 |
0 |
None |
MTK811 |
None |
CA00331182 |
E |
SFY2013-14 |
250000017 |
JOHN F. KENNEDY MEMORIAL HOSPITAL |
Non-LTC |
GACH |
General Acute Care Hospital |
Riverside |
2014-03-07 00:00:00 |
250010454 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to CDPH (HSC 1280.15(b)(1)) |
Breach to person/entity outside facility/hc system |
None |
2012-10-15 00:00:00 |
2012-10-15 00:00:00 |
No |
2014-03-28 00:00:00 |
None |
FTR BR |
None |
900 |
900 |
0 |
900 |
0 |
None |
MTK811 |
None |
CA00331182 |
E |
SFY2013-14 |
250000017 |
JOHN F. KENNEDY MEMORIAL HOSPITAL |
Non-LTC |
GACH |
General Acute Care Hospital |
Riverside |
2014-08-11 00:00:00 |
250010926 |
Closed |
Administrative Penalty |
AP - Immediate Jeopardy (HSC 1280.3) |
Other Immediate Jeopardy (not an AE) |
None |
2011-10-06 00:00:00 |
2011-10-06 00:00:00 |
Yes |
2015-03-05 00:00:00 |
2015-02-23 00:00:00 |
AP IJ |
AP IJ |
100000 |
77250 |
0 |
77250 |
0 |
None |
YXPK11 |
Y |
CA00286109 |
B |
SFY2014-15 |
250000017 |
JOHN F. KENNEDY MEMORIAL HOSPITAL |
Non-LTC |
GACH |
General Acute Care Hospital |
Riverside |
2016-05-26 00:00:00 |
250012294 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to CDPH (HSC 1280.15(b)(1)) |
Breach to person/entity outside facility/hc system |
None |
2016-02-21 00:00:00 |
2016-02-21 00:00:00 |
No |
2016-06-17 00:00:00 |
None |
FTR BR |
None |
100 |
100 |
-25 |
75 |
0 |
None |
H9T311 |
None |
CA00480624 |
D |
SFY2015-16 |
250000017 |
JOHN F. KENNEDY MEMORIAL HOSPITAL |
Non-LTC |
GACH |
General Acute Care Hospital |
Riverside |
2016-05-31 00:00:00 |
250012295 |
Closed |
Failure to Report Penalty |
Failure to Report Breach to Resident (HSC 1280.15(b)(2)) |
Breach to person/entity outside facility/hc system |
None |
2016-02-21 00:00:00 |
2016-02-21 00:00:00 |
No |
2016-06-21 00:00:00 |
None |
FTR RES |
None |
100 |
100 |
-25 |
75 |
0 |
None |
H9T311 |
None |
CA00480624 |
D |
SFY2015-16 |
250000017 |
JOHN F. KENNEDY MEMORIAL HOSPITAL |
Non-LTC |
GACH |
General Acute Care Hospital |
Riverside |
2017-10-26 00:00:00 |
250013577 |
Closed |
Failure to Report Penalty |
Failure to Report Adverse Events to CDPH (HSC 1280.4) |
AE17 - Stage 3 or 4 ulcer acquired after admission |
None |
2016-07-12 00:00:00 |
2016-07-12 00:00:00 |
No |
2017-11-17 00:00:00 |
None |
FTR AE |
None |
9300 |
9300 |
0 |
9300 |
0 |
None |
1GQP11 |
N |
CA00506126 |
C |
SFY2017-18 |
250000017 |
JOHN F. KENNEDY MEMORIAL HOSPITAL |
Non-LTC |
GACH |
General Acute Care Hospital |
Riverside |
2018-06-12 00:00:00 |
250014148 |
Open |
Administrative Penalty |
AP - Immediate Jeopardy (HSC 1280.3) |
Other Immediate Jeopardy (not an AE) |
None |
2017-09-05 00:00:00 |
2017-09-05 00:00:00 |
Yes |
2018-07-03 00:00:00 |
2018-08-21 00:00:00 |
AP IJ |
None |
75000 |
75000 |
0 |
0 |
75000 |
None |
ENQQ11 |
Y |
CA00552371 |
B |
SFY2017-18 |
250000017 |
JOHN F. KENNEDY MEMORIAL HOSPITAL |
Non-LTC |
GACH |
General Acute Care Hospital |
Riverside |
2019-10-23 00:00:00 |
250015472 |
Closed |
Failure to Report Penalty |
Failure to Report Adverse Events to CDPH (HSC 1280.4) |
AE28 - Adverse event or series of adverse events |
None |
2019-08-05 00:00:00 |
2019-08-05 00:00:00 |
No |
2019-11-13 00:00:00 |
None |
FTR AE |
None |
1100 |
1100 |
0 |
1100 |
0 |
None |
G5B211 |
N |
CA00651469 |
C |
SFY2019-20 |
250000017 |
JOHN F. KENNEDY MEMORIAL HOSPITAL |
Non-LTC |
GACH |
General Acute Care Hospital |
Riverside |
2022-02-04 00:00:00 |
250017321 |
Closed |
Failure to Report Penalty |
Failure to Report Adverse Events to CDPH (HSC 1280.4) |
AE17 - Stage 3 or 4 ulcer acquired after admission |
None |
2021-05-11 00:00:00 |
2021-05-11 00:00:00 |
No |
2022-02-28 00:00:00 |
None |
FTR AE |
None |
400 |
400 |
0 |
400 |
0 |
None |
USO211 |
N |
CA00737297, CA00737297 |
B, B |
SFY2021-22 |
250000017 |
JOHN F. KENNEDY MEMORIAL HOSPITAL |
Non-LTC |
GACH |
General Acute Care Hospital |
Riverside |
2024-02-01 00:00:00 |
250020152 |
Open |
Administrative Penalty |
AP - Breach (HSC 1280.15) |
Deliberate breach of PHI by health care worker |
None |
2021-04-10 00:00:00 |
2021-04-10 00:00:00 |
No |
2024-06-19 00:00:00 |
None |
AP BR |
None |
20000 |
20000 |
0 |
0 |
20000 |
None |
Z71W11 |
None |
CA00736640 |
D |
SFY2023-24 |
250000017 |
JOHN F. KENNEDY MEMORIAL HOSPITAL |
Non-LTC |
GACH |
General Acute Care Hospital |
Riverside |
2024-02-01 00:00:00 |
250020189 |
Open |
Failure to Report Penalty |
Failure to Report Breach to CDPH (HSC 1280.15(b)(1)) |
Deliberate breach of PHI by health care worker |
None |
2021-04-10 00:00:00 |
2021-04-10 00:00:00 |
No |
2024-02-23 00:00:00 |
None |
FTR BR |
None |
800 |
800 |
0 |
0 |
800 |
None |
Z71W11 |
None |
CA00736640 |
D |
SFY2023-24 |