Nursing homes › California › San Bruno Skilled Nursing
890 El Camino Real, San Bruno, CA 94066 · 6505837768 · 45 certified beds
Per CMS filings, this facility is affiliated with Pacs Group, a group operating 281 facilities in 16 states. Group record: average rating 2.8/5, 26 abuse citation icons, 13 facilities on the Special Focus list, $8,841,332 in federal fines. This facility rates above its group average (2.8/5).
Total nurse staffing: 4.42 (California median: 4.24). RN hours: 0.56. Weekend total: 4.07. Nursing staff turnover: 37%.
All-time on record: 36 deficiency citations. Below: citations from 2023 onward (severity letters explained in methodology).
| Survey date | Deficiency | Sev. | Type | Status |
|---|---|---|---|---|
| 2025-12-30 | Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge. | D | complaint | corrected 2026-03-10 |
| 2025-12-05 | Honor the resident's right to organize and participate in resident/family groups in the facility. | E | Health | corrected 2025-12-26 |
| 2025-12-05 | Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. | E | Health | corrected 2025-12-26 |
| 2025-12-05 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | E | Health | corrected 2025-12-26 |
| 2025-12-05 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | D | Health | corrected 2025-12-26 |
| 2025-12-05 | PASARR screening for Mental disorders or Intellectual Disabilities | D | Health | corrected 2025-12-26 |
| 2025-12-05 | Ensure services provided by the nursing facility meet professional standards of quality. | D | Health | corrected 2025-12-26 |
| 2025-12-05 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | Health | corrected 2025-12-26 |
| 2025-12-05 | Provide activities to meet all resident's needs. | D | Health | corrected 2025-12-26 |
| 2025-12-05 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Health | corrected 2025-12-26 |
| 2025-12-05 | Provide safe and appropriate respiratory care for a resident when needed. | D | Health | corrected 2025-12-26 |
| 2025-12-05 | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | Health | corrected 2025-12-26 |
| 2025-12-05 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | Health | corrected 2025-12-26 |
| 2025-12-05 | Provide and implement an infection prevention and control program. | D | complaint | corrected 2025-12-26 |
| 2025-11-12 | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | D | complaint | corrected 2025-11-26 |
| 2025-08-01 | Assess the resident when there is a significant change in condition | D | complaint | corrected 2025-09-08 |
| 2024-06-14 | Provide at least one room set aside to use as a resident dining room and for activities, that is a good size, with good lighting, air flow and furniture. | F | Health | corrected 2024-07-17 |
| 2024-06-14 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | Health | corrected 2024-07-17 |
| 2024-06-14 | Allow residents to self-administer drugs if determined clinically appropriate. | D | Health | corrected 2024-07-17 |
| 2024-06-14 | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | D | Health | corrected 2024-07-17 |
| 2024-06-14 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | Health | corrected 2024-07-17 |
| 2024-06-14 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Health | corrected 2024-07-17 |
| 2024-06-14 | Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. | D | Health | corrected 2024-07-17 |
| 2024-06-14 | Assess the resident when there is a significant change in condition | D | Health | corrected 2024-07-17 |
| 2024-06-14 | Assure that each resident’s assessment is updated at least once every 3 months. | D | Health | corrected 2024-07-17 |
| 2024-06-14 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Health | corrected 2024-07-17 |
| 2024-06-14 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | Health | corrected 2024-07-17 |
| 2024-06-14 | Ensure services provided by the nursing facility meet professional standards of quality. | D | Health | corrected 2024-07-17 |
| 2024-06-14 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Health | corrected 2024-07-17 |
| 2024-06-14 | Ensure medication error rates are not 5 percent or greater. | D | Health | corrected 2024-07-17 |
| 2024-06-14 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | D | Health | corrected 2024-07-17 |
| 2024-06-14 | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | D | Health | corrected 2024-07-17 |
| 2024-06-14 | Provide and implement an infection prevention and control program. | D | Health | corrected 2024-07-17 |
| 2023-02-10 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Health | corrected 2023-03-13 |
| 2023-02-10 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | Health | corrected 2023-03-13 |
| 2023-02-10 | Ensure medication error rates are not 5 percent or greater. | D | Health | corrected 2023-03-13 |
No federal fines or payment denials on record.
| Name | Role | Type | % | Since |
|---|---|---|---|---|
| PROVIDENCE GROUP NORTH LLC | 5% Or Greater Direct Ownership Interest | Organization | 100% | since 03/01/2015 |
| APT, FREDERICK | Corporate Officer | Individual | NOT APPLICABLE | since 01/01/2024 |
| HANCOCK, MARK | Corporate Officer | Individual | NOT APPLICABLE | since 02/10/2021 |
| JERGENSEN, JOSHUA | Corporate Officer | Individual | NOT APPLICABLE | since 01/01/2024 |
| MITCHELL, JOHN | Corporate Officer | Individual | NOT APPLICABLE | since 01/01/2024 |
Source: CMS Provider Data Catalog (July 2026 release) — provider file, deficiency file, ownership file, penalty file. CCN 555276. Corrections: data@carerecords.org.