Golden Living Center - Hy-pana
4545 Shelley Court, Stockton, CA 95207


Golden Living Center - Hy-pana is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 055201. The address is 4545 Shelley Court, Stockton, CA 95207. The zip code is 95207. The phone number is 2094770271.


Golden Living Center - Hy-pana · 4545 Shelley Court, Stockton, CA 95207

Federal Provider Number 055201
Provider Name GOLDEN LIVING CENTER - HY-PANA
Address 4545 SHELLEY COURT
STOCKTON, CA 95207
Phone Number 2094770271
SSA County Code 490
County Name San Joaquin
Ownership Type For profit - Corporation
Certified Beds 119
Certified Beds Residents 101
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name GGNSC STOCKTON LP
Date First Approved to Provide Medicare Medicaid Services 01/01/1967
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 2
Health Inspection Rating 2
Quality Measure Rating 3
Staffing Rating 3
RN Staffing Rating 3
Reported CNA Staffing Hours per Resident per Day 2.25149
Reported LPN Staffing Hours per Resident per Day 0.90792
Reported RN Staffing Hours per Resident per Day 0.5198
Reported Licensed Staffing Hours per Resident per Day 1.42772
Reported Total Nurse Staffing Hours per Resident per Day 3.67921
Reported Physical Therapist Staffing Hours per Resident Per Day 0.05099
Expected CNA Staffing Hours per Resident per Day 2.36343
Expected LPN Staffing Hours per Resident per Day 0.60874
Expected RN Staffing Hours per Resident per Day 0.93759
Expected Total Nurse Staffing Hours per Resident per Day 3.90976
Adjusted CNA Staffing Hours per Resident per Day 2.33748
Adjusted LPN Staffing Hours per Resident per Day 1.23792
Adjusted RN Staffing Hours per Resident per Day 0.41425
Adjusted Total Nurse Staffing Hours per Resident per Day 3.79321
Cycle 1 Total Number of Health Deficiencies 22
Cycle 1 Number of Standard Health Deficiencies 12
Cycle 1 Number of Complaint Health Deficiencies 11
Cycle 1 Health Deficiency Score 120
Cycle 1 Standard Survey Health Date 03/03/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 120
Cycle 2 Total Number of Health Deficiencies 12
Cycle 2 Number of Standard Health Deficiencies 9
Cycle 2 Number of Complaint Health Deficiencies 3
Cycle 2 Health Deficiency Score 64
Cycle 2 Standard Health Survey Date 02/19/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 64
Cycle 3 Total Number of Health Deficiencies 7
Cycle 3 Number of Standard Health Deficiencies 3
Cycle 3 Number of Complaint Health Deficiencies 4
Cycle 3 Health Deficiency Score 44
Cycle 3 Standard Health Survey Date 03/13/2015
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 44
Total Weighted Health Survey Score 88.667
Number of Facility Reported Incidents 15
Number of Substantiated Complaints 6
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Golden Living Center - Hy-pana

Owner Name Role Association Date
BURTON, LORI (Individual) DIRECTOR since 01/22/2007
CHAVIS, TINA (Individual) DIRECTOR since 01/22/2007
CHAVIS, TINA (Individual) OFFICER since 08/15/2006
CITIBANK N.A. (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 05/04/2011
COLEMAN, BRIGITTE (Individual) MANAGING EMPLOYEE since 04/01/2006
DRUMM CORP (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/15/2006
FILLMORE STRATEGIC INVESTORS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/15/2006
FINN, NICHOLAS (Individual) OFFICER since 11/03/2009
GGNSC EQUITY HOLDINGS LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/21/2005
GGNSC EQUITY HOLDINGS LLC (Organization) PARTNERSHIP INTEREST since 12/21/2005
GGNSC HOLDINGS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/15/2006
GGNSC STOCKTON GP LLC (Organization) PARTNERSHIP INTEREST since 04/19/2006
GOLDEN GATE NATIONAL SENIOR CARE LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/02/2005
GOLDEN GATE NATIONAL SENIOR CARE LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/15/2006
GROBMYER, JOHN (Individual) DIRECTOR since 01/22/2007
HELM, PAUL (Individual) OFFICER since 01/02/2012
JOSEPH, LARRY (Individual) DIRECTOR since 01/22/2007
JOSEPH, LARRY (Individual) OFFICER since 08/15/2006
KARICHER, MICHAEL (Individual) OFFICER since 01/02/2012
MOLASKEY, NATALIE (Individual) MANAGING EMPLOYEE since 07/30/2012
MORRIS, KEVIN (Individual) OFFICER since 09/10/2012
RASMUSSEN-JONES, HOLLY (Individual) DIRECTOR since 01/22/2007
RASMUSSEN-JONES, HOLLY (Individual) OFFICER since 08/15/2006
ROBERTS, KEVIN (Individual) DIRECTOR since 01/22/2007
ROGERS, STACEY (Individual) OFFICER since 04/19/2012
SALAMONE, SALVATORE (Individual) DIRECTOR since 01/22/2007
SALAMONE, SALVATORE (Individual) OFFICER since 01/15/2007
SUTTON, HOLLY (Individual) DIRECTOR since 01/22/2007
SUTTON, HOLLY (Individual) OFFICER since 08/15/2006
SWARTZ, GREGORY (Individual) DIRECTOR since 01/22/2007
SWARTZ, GREGORY (Individual) OFFICER since 08/15/2006
TRUITT, ANN (Individual) DIRECTOR since 01/22/2007
TRUITT, ANN (Individual) OFFICER since 08/15/2006
VARDELL, KATHLEEN (Individual) OFFICER since 08/01/2012
WASHINGTON STATE INVESTMENT BOARD (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 03/15/2006
WIFFLER, PAXTON (Individual) DIRECTOR since 01/22/2007
WILLIAMS, ROBERTA (Individual) DIRECTOR since 01/22/2007
WILLIAMS, ROBERTA (Individual) OFFICER since 08/15/2006

street_number: 4545
route: Shelley Court (Shelley Ct)
neighborhood, political: Pacific
locality, political: Stockton
admin_level_2, political: San Joaquin County
admin_level_1, political: California (CA)
country, political: United States (US)
postal_code: 95207
postal_code_suffix: 7232
types : premise
latitude: 37.9926088
longitude: -121.3037545
latlng: (37.9926088, -121.3037545)


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