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Skilled nursing facility · CMS certification number 555734

CHILDRENS HC ORG NO CA -PEDIATRIC HOSPITAL D/P SNF

CAMPBELL, California · Medicare and Medicaid

Certified beds, as filed in Care Compare: 27

Finances, as filed

From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.

Cost report for 1 January 2024 to 31 December 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 11 September 2025.

None of these figures is carried on this report.

CMS report record 1439412, read from the public cost report file SNF10FY2024.zip.

Fiscal year 2023, ended 31 December 2023

Cost report for 1 January 2023 to 31 December 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 11 September 2024.

None of these figures is carried on this report.

CMS report record 1394570, read from the public cost report file SNF10FY2023.zip.

Fiscal year 2022, ended 31 December 2022

Cost report for 1 January 2022 to 31 December 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 13 September 2023.

None of these figures is carried on this report.

CMS report record 1364652, read from the public cost report file SNF10FY2022.zip.

Fiscal year 2021, ended 31 December 2021

Cost report for 1 January 2021 to 31 December 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 21 September 2022.

None of these figures is carried on this report.

CMS report record 1333471, read from the public cost report file SNF10FY2021.zip.

Fiscal year 2020, ended 31 December 2020

Cost report for 1 January 2020 to 31 December 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 20 July 2021.

None of these figures is carried on this report.

CMS report record 1289835, read from the public cost report file SNF10FY2020.zip.

Fiscal year 2019, ended 31 December 2019

Cost report for 1 January 2019 to 31 December 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 19 August 2020.

None of these figures is carried on this report.

CMS report record 1264277, read from the public cost report file SNF10FY2019.zip.

Fiscal year 2018, ended 31 December 2018

Cost report for 1 January 2018 to 31 December 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 15 April 2020.

None of these figures is carried on this report.

CMS report record 1253533, read from the public cost report file SNF10FY2018.zip.

Fiscal year 2017, ended 31 December 2017

Cost report for 1 January 2017 to 31 December 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 15 February 2019.

None of these figures is carried on this report.

CMS report record 1219841, read from the public cost report file SNF10FY2017.zip.

Nurse staffing

Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.

The staffing record →

Ownership, as filed with CMS

Care Compare

As filed in the CMS file dated 1 August 2026 (Care Compare ownership).

Owner or managerRoleTypeOwnership percentageAssociation
INNOVATIONS HEALTH SYSTEMS LLC5% OR GREATER DIRECT OWNERSHIP INTERESTOrganizationNO PERCENTAGE PROVIDEDsince 01/01/2017
MCGUIRE, KENNETH5% OR GREATER DIRECT OWNERSHIP INTERESTIndividualNO PERCENTAGE PROVIDEDsince 01/01/2017
NICCUM, DAN5% OR GREATER DIRECT OWNERSHIP INTERESTIndividualNO PERCENTAGE PROVIDEDsince 01/01/2017
MCGUIRE, KENNETHCORPORATE DIRECTORIndividualNOT APPLICABLEsince 01/01/2017
NICCUM, DANCORPORATE DIRECTORIndividualNOT APPLICABLEsince 01/01/2016
MCGUIRE, KENNETHCORPORATE OFFICERIndividualNOT APPLICABLEsince 01/01/2017
NICCUM, DANCORPORATE OFFICERIndividualNOT APPLICABLEsince 01/01/2016
INNOVATIONS HEALTH SYSTEMS LLCOPERATIONAL/MANAGERIAL CONTROLOrganizationNOT APPLICABLEsince 01/01/2017
MCGUIRE, KENNETHOPERATIONAL/MANAGERIAL CONTROLIndividualNOT APPLICABLEsince 01/01/2017
NICCUM, DANOPERATIONAL/MANAGERIAL CONTROLIndividualNOT APPLICABLEsince 01/01/2017
MCGUIRE, KENNETHW-2 MANAGING EMPLOYEEIndividualNOT APPLICABLEsince 01/01/2017
NICCUM, DANW-2 MANAGING EMPLOYEEIndividualNOT APPLICABLEsince 01/01/2017

Medicare enrollment

As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of CHILDRENS RECOVERY CENTER 1 LLC (enrollment ID O20180928001733).

OwnerIndividual or organizationRoleOwnership percentageAssociation dateDescribed in the filing as
DAN T NICCUMIndividual5% OR GREATER DIRECT OWNERSHIP INTEREST501/1/2017
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
INNOVATIONS HEALTH SYSTEMS LLCOrganization5% OR GREATER DIRECT OWNERSHIP INTEREST1001/1/2017
Private equity company: No
Real estate investment trust: No
Holding company: No
KENNETH S MCGUIREIndividual5% OR GREATER DIRECT OWNERSHIP INTEREST501/1/2017
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
DAN T NICCUMIndividualCORPORATE DIRECTOR501/1/2016
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
KENNETH S MCGUIREIndividualCORPORATE DIRECTOR501/1/2017
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
DAN T NICCUMIndividualCORPORATE OFFICER501/1/2016
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
KENNETH S MCGUIREIndividualCORPORATE OFFICER501/1/2017
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
DAN T NICCUMIndividualOPERATIONAL/MANAGERIAL CONTROL501/1/2017
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
INNOVATIONS HEALTH SYSTEMS LLCOrganizationOPERATIONAL/MANAGERIAL CONTROL1001/1/2017
Private equity company: No
Real estate investment trust: No
Holding company: No
KENNETH S MCGUIREIndividualOPERATIONAL/MANAGERIAL CONTROL1001/1/2017
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
DAN T NICCUMIndividualW-2 MANAGING EMPLOYEE501/1/2017
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
KENNETH S MCGUIREIndividualW-2 MANAGING EMPLOYEE1001/1/2017
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.

Changes in ownership

No change in ownership appears in the CMS files on record since 20 September 2022.

Recent changes on this record

  • 11 September 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
  • 11 September 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
  • 13 September 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
  • 21 September 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
  • 20 July 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
  • 19 August 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
  • 15 April 2020: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
  • 15 February 2019: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip

Inspections

Inspection cycleHealth inspectionFire safety inspectionHealth deficienciesFire safety deficiencies
126 July 202426 July 202458
28 July 20228 July 202243
331 October 201931 October 201977

From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.

Deficiencies cited

16 deficiencies on file, newest inspection first
Inspection dateInspection typeTagCategoryWhat was citedScope and severityComplaintCorrectedCorrection date
10 October 2024HealthF 0658Resident Assessment and Care Planning DeficienciesEnsure services provided by the nursing facility meet professional standards of quality.DYesDeficient, Provider has date of correction17 October 2024
26 July 2024HealthF 0658Resident Assessment and Care Planning DeficienciesEnsure services provided by the nursing facility meet professional standards of quality.ENoDeficient, Provider has date of correction31 August 2024
26 July 2024HealthF 0758Pharmacy Service DeficienciesImplement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.DNoDeficient, Provider has date of correction31 August 2024
26 July 2024HealthF 0812Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.ENoDeficient, Provider has date of correction31 August 2024
26 July 2024HealthF 0880Infection Control DeficienciesProvide and implement an infection prevention and control program.ENoDeficient, Provider has date of correction31 August 2024
26 July 2024HealthF 0921Environmental DeficienciesMake sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.DNoDeficient, Provider has date of correction31 August 2024
8 July 2022HealthF 0658Resident Assessment and Care Planning DeficienciesEnsure services provided by the nursing facility meet professional standards of quality.DNoDeficient, Provider has date of correction30 July 2022
8 July 2022HealthF 0812Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.ENoDeficient, Provider has date of correction22 July 2022
8 July 2022HealthF 0880Infection Control DeficienciesProvide and implement an infection prevention and control program.ENoDeficient, Provider has date of correction5 August 2022
31 October 2019HealthF 0656Resident Assessment and Care Planning DeficienciesDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.DNoDeficient, Provider has date of correction22 November 2019
31 October 2019HealthF 0657Resident Assessment and Care Planning DeficienciesDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.DNoDeficient, Provider has date of correction22 November 2019
31 October 2019HealthF 0658Resident Assessment and Care Planning DeficienciesEnsure services provided by the nursing facility meet professional standards of quality.DNoDeficient, Provider has date of correction22 November 2019
31 October 2019HealthF 0758Pharmacy Service DeficienciesImplement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.DNoDeficient, Provider has date of correction22 November 2019
31 October 2019HealthF 0759Pharmacy Service DeficienciesEnsure medication error rates are not 5 percent or greater.DNoDeficient, Provider has date of correction22 November 2019
31 October 2019HealthF 0802Nutrition and Dietary DeficienciesProvide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.DNoDeficient, Provider has date of correction22 November 2019
31 October 2019HealthF 0908Environmental DeficienciesKeep all essential equipment working safely.ENoDeficient, Provider has date of correction22 November 2019

From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.

Penalties

Penalty dateTypeFine amountPayment denial beganPayment denial, daysFine ID
2 October 2023Fine$3,145128953

From the Care Compare penalties file NH_Penalties_Aug2026.csv, processed on 1 August 2026.

Care Compare provider information

FieldAs filed
Provider TypeMedicare and Medicaid
Ownership TypeFor profit - Limited Liability company
Legal Business NameCHILDRENS RECOVERY CENTER 1 LLC
Date First Approved to Provide Medicare and Medicaid Services1999-03-03
Provider Resides in HospitalN
Continuing Care Retirement CommunityN
UrbanY
County/ParishSanta Clara
Telephone Number4085583640
Provider Changed Ownership in Last 12 MonthsN
With a Resident and Family CouncilResident
Automatic Sprinkler Systems in All Required AreasYes
Number of Certified Beds27
Average Number of Residents per Day26.8
Overall Rating5
Health Inspection Rating5
QM Rating5
Long-Stay QM Rating5
Processing Date2026-08-01

From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.

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The citable document for CHILDRENS HC ORG NO CA -PEDIATRIC HOSPITAL D/P SNF

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