General Information: A & C CONVALESCENT HOSPITAL OF MILLBRAE
Nursing home name A & C CONVALESCENT HOSPITAL OF MILLBRAE
Address33 MATEO AVENUE
MILLBRAE, CA 94030
Phone number (650) 689-5784
Located within a hospital No
Type of ownership For profit - Corporation
Owner operates multiple homesYes
Accept Medicare or Medicaid Medicare and Medicaid
Continue Care Retirement CommunityNo
Resident and family councils Both
Certified number of beds 138
Total number of residents 134
Perc of occupied beds 97
Sprinkler status Yes
Number of Facility Reported Incidents0
Number of Substantiated Complaints0
Number of Fines0
Total Amount of Fines$0
Total Number of Penalties0
Total Number of Penalties0
Ratings Summary: A & C CONVALESCENT HOSPITAL OF MILLBRAE
Overall rating 4
4
Nursing Home Staffing 4
4
Registered Nurses only 5
5
Health Inspections 2
2
Quality Measures 5
5
Nursing Home Staffing Info: A & C CONVALESCENT HOSPITAL OF MILLBRAE
National AverageCalifornia AverageA & C CONVALESCENT HOSPITAL OF MILLBRAE
Overall staff rating NA NA 4
4
Registered Nurses only rating NANA 5
5
Total Number of Residents NA NA 134
Total Number of Nurse Staff Hours per Resident per Day 4.11 hours 4.49 hours 3.79 hours
Total Number of Licensed Nurse Staff Hours per Resident per Day 1.64 hours 1.8 hours 1.43 hours
Registered Nurses Hours per Residents per Day 0.81 hours 0.88 hours 1.06 hours
Licensed Practical or Vacation Nurses Hours per Resident per Day 0.83 hours 0.92 hours 0.37 hours
Certified Nursing Assistants Hours per Residents per Day 2.47 hours 2.69 hours 2.36 hours
Physical Therapy Staffing Hours per Resident Per Day 0.1 hours 0.14 hours 0.04 hours
Health Survey: A & C CONVALESCENT HOSPITAL OF MILLBRAE
Heath Survey Summary on 2013-04-12
Total Number of Health Deficiencies 15
Scope and Severity of most Severe Health Deficiency Isolated/Actual harm
Heath Survey Summary on 2012-02-29
Total Number of Health Deficiencies 7
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Heath Survey Summary on 2011-01-18
Total Number of Health Deficiencies 11
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Health Survey Details: A & C CONVALESCENT HOSPITAL OF MILLBRAE
Inspection Results: 04/12/2013
Corrected Deficiency Scope and Severity
05/23/2013 Try to resolve each resident's complaints quickly. Isolated/Minimal harm or potential for actual harm
05/23/2013 Provide housekeeping and maintenance services. Isolated/Minimal harm or potential for actual harm
05/23/2013 Ensure each resident receives an accurate assessment by a qualified health professional. Isolated/Minimal harm or potential for actual harm
05/23/2013 Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Isolated/Minimal harm or potential for actual harm
05/23/2013 Provide necessary care and services to maintain or improve the highest well being of each resident . Isolated/Actual harm
05/23/2013 Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. Isolated/Minimal harm or potential for actual harm
05/23/2013 Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. Isolated/Minimal harm or potential for actual harm
05/23/2013 Ensure that residents are safe from serious medication errors. Pattern/Minimal harm or potential for actual harm
05/23/2013 Store, cook, and serve food in a safe and clean way. Pattern/Minimal harm or potential for actual harm
05/23/2013 Make sure that doctors see a resident's plan of care at every visit and make notes about progress and orders in writing. Isolated/Minimal harm or potential for actual harm
05/23/2013 Provide routine and emergency drugs through a licensed pharmacist and only under the general supervision of a licensed nurse. Pattern/Minimal harm or potential for actual harm
05/23/2013 Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. Pattern/Minimal harm or potential for actual harm
05/23/2013 Have a program that investigates, controls and keeps infection from spreading. Pattern/Minimal harm or potential for actual harm
05/23/2013 Make sure that a working call system is available in each resident's room or bathroom and bathing area. Isolated/Minimal harm or potential for actual harm
05/23/2013 Keep accurate, complete and organized clinical records on each resident that meet professional standards. Isolated/Minimal harm or potential for actual harm
Inspection Results: 02/29/2012
Corrected Deficiency Scope and Severity
03/20/2012 Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses. Isolated/Minimal harm or potential for actual harm
03/20/2012 Store, cook, and serve food in a safe and clean way. Pattern/Minimal harm or potential for actual harm
03/20/2012 Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. Isolated/Minimal harm or potential for actual harm
03/20/2012 Provide routine and emergency drugs through a licensed pharmacist and only under the general supervision of a licensed nurse. Pattern/Minimal harm or potential for actual harm
03/20/2012 Make sure each resident has 1) at least one window to the outside in a room; 2) a room at or above ground level; 3) adequate bedding; 4) furniture that meets the resident's needs; or 5) adequate closet space. Isolated/Minimal harm or potential for actual harm
03/20/2012 Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Isolated/Minimal harm or potential for actual harm
03/20/2012 Keep accurate, complete and organized clinical records on each resident that meet professional standards. Isolated/Minimal harm or potential for actual harm
Inspection Results: 01/18/2011
Corrected Deficiency Scope and Severity
02/16/2011 Provide a safe, clean, comfortable and home-like environment; and allow residents to use personal belongings to the extent possible. Pattern/Minimal harm or potential for actual harm
02/16/2011 Reasonably accommodate the needs and preferences of each resident. Isolated/Minimal harm or potential for actual harm
02/16/2011 Allow residents to self-administer drugs if determined safe. Isolated/Minimal harm or potential for actual harm
02/16/2011 Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Isolated/Minimal harm or potential for actual harm
02/16/2011 Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. Isolated/Minimal harm or potential for actual harm
02/16/2011 Store, cook, and serve food in a safe and clean way. Pattern/Minimal harm or potential for actual harm
02/16/2011 Have a program that investigates, controls and keeps infection from spreading. Isolated/Minimal harm or potential for actual harm
02/16/2011 Keep all essential equipment working safely. Isolated/Minimal harm or potential for actual harm
02/16/2011 Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Pattern/Minimal harm or potential for actual harm
02/16/2011 Have enough backup water supply for essential areas of the nursing home. Pattern/Minimal harm or potential for actual harm
02/16/2011 Be licensed under State and local laws. Isolated/Minimal harm or potential for actual harm

Fire Safety Survey: A & C CONVALESCENT HOSPITAL OF MILLBRAE
Fire Safety Survey Summary on 2013-04-17
Total Number of Fire SafetyDeficiencies 3
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2012-03-07
Total Number of Fire SafetyDeficiencies 11
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2011-01-20
Total Number of Fire SafetyDeficiencies 13
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Fire Safety Survey: A & C CONVALESCENT HOSPITAL OF MILLBRAE
Fire Safety Survey Results: 04/17/2013
Corrected Deficiency Severity
05/06/2013 Corridor and hallway doors that block smoke. Isolated/Minimal harm or potential for actual harm
05/06/2013 Properly protected cooking facilities. Isolated/Minimal harm or potential for actual harm
05/06/2013 Properly installed electrical wiring and equipment. Pattern/Minimal harm or potential for actual harm
Fire Safety Survey Results: 03/07/2012
Corrected Deficiency Severity
04/05/2012 Properly installed electrical wiring and equipment. Isolated/Minimal harm or potential for actual harm
04/05/2012 Proper medical gas storage and administration areas. Pattern/Minimal harm or potential for actual harm
04/05/2012 Approved construction type or materials. Widespread/Potential for minimal harm
04/05/2012 Corridor and hallway doors that block smoke. Isolated/Minimal harm or potential for actual harm
04/05/2012 Special areas constructed so that walls can resist fire for one hour or an approved fire extinguishing system. Isolated/Minimal harm or potential for actual harm
04/05/2012 Exits that are accessible at all times. Pattern/Minimal harm or potential for actual harm
04/05/2012 Emergency lighting that can last at least 1 1/2 hours. Isolated/Minimal harm or potential for actual harm
04/05/2012 Portable fire extinguishers. Widespread/Potential for minimal harm
04/05/2012 Properly protected cooking facilities. Widespread/Potential for minimal harm
04/05/2012 Restrictions on the use of flammable curtains. Isolated/Minimal harm or potential for actual harm
04/05/2012 Weekly inspections and monthly testing of generators. Widespread/Potential for minimal harm
Fire Safety Survey Results: 01/20/2011
Corrected Deficiency Severity
03/03/2011 Automatic sprinkler systems that have been maintained in working order. Isolated/Minimal harm or potential for actual harm
03/03/2011 Portable fire extinguishers. Pattern/Minimal harm or potential for actual harm
03/03/2011 Approved construction type or materials. Pattern/Minimal harm or potential for actual harm
03/03/2011 Corridor and hallway doors that block smoke. Isolated/Minimal harm or potential for actual harm
03/03/2011 Signs that state that exit doors are to be kept closed. Pattern/Minimal harm or potential for actual harm
03/03/2011 Walls that prevent smoke from passing through and would resist fire for at least one hour. Widespread /Minimal harm or potential for actual harm
03/03/2011 Smoke barrier doors that can resist smoke for at least 20 minutes. Pattern/Minimal harm or potential for actual harm
03/03/2011 Special areas constructed so that walls can resist fire for one hour or an approved fire extinguishing system. Isolated/Minimal harm or potential for actual harm
03/03/2011 Emergency lighting that can last at least 1 1/2 hours. Isolated/Minimal harm or potential for actual harm
03/03/2011 An approved installation, maintenance and testing program for fire alarm systems. Isolated/Minimal harm or potential for actual harm
03/03/2011 Heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Isolated/Minimal harm or potential for actual harm
03/03/2011 Properly protected cooking facilities. Isolated/Minimal harm or potential for actual harm
03/03/2011 Properly installed electrical wiring and equipment. Pattern/Minimal harm or potential for actual harm

Resident Complaints: A & C CONVALESCENT HOSPITAL OF MILLBRAE
Not available

Quality Measures: A & C CONVALESCENT HOSPITAL OF MILLBRAE
Quality Measures National Average California Average A & C CONVALESCENT HOSPITAL OF MILLBRAE
Overall quality rating NA NA 5
5
Long-Stay Residents
Percent of Long Stay Residents Whose Need for Help with ADLs has Increased 15.4% 11.7% 10.2%
Percent of Long Stay Residents Who Self Report Moderate to Severe Pain 8.3% 5.9% 3.1%
Percent of High Risk Long Stay Residents With Pressure Ulcers 6.1% 6.2% 2.3%
Percent of Long Stay Residents Who Lose Too Much Weight 7.2% 5.8% 3.6%
Percent of Low Risk Long Stay Residents Who Lose Control of Their Bowel or Bladder 43.9% 45.3% 39.9%
Percent of Long Stay Residents with a Catheter Inserted and Left in Their Bladder 3.2% 3.3% 1.3%
Percent of Long Stay Residents With a Urinary Tract Infection 6.2% 5.3% 8.8%
Percent of Long Stay Residents Who Have Depressive Symptoms 6.3% 1.8% 0.3%
Percent of Long Stay Residents Who Were Physically Restrained 1.4% 2.1% 0.0%
Percent of Long Stay Residents Experiencing One or More Falls with Major Injury 3.2% 1.6% 2.0%
Percent of Long Stay Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine 92.7% 92.3% 96.6%
Percent of Long Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 94.3% 94.6% 98.7%
Percent of Long Stay Residents Who Received an Antipsychotic Medication 20.7% 16.5% 10.8%
Short-Stay Residents
Percent of Short Stay Residents Who Self Report Moderate to Severe Pain 19.2% 16.9% 7.7%
Percent of Short Stay Residents With Pressure Ulcers That Are New or Worsened 1.2% 0.9% 5.7%
Percent of Short Stay Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine 83.4% 81.1% 74.2%
Percent of Short Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 82.4% 79.8% 67.6%
Percent of Short Stay Residents Who Newly Received an Antipsychotic Medication 2.6% 2.0% 5.1%

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