College Vista Conv Hospital - Los Angeles Nursing Home
General Information
UPDATEFederal Provider Number
555030
Provider Name
COLLEGE VISTA CONV HOSPITAL
Provider Address
4681 EAGLE ROCK BLVD.
LOS ANGELES, CA 90041
LOS ANGELES, CA 90041
Provider Phone Number
2132578151
Provider SSA County
200
Provider County Name
Los Angeles
Ownership Type
For profit - Corporation
Number of Certified Beds
49
Number of Residents in Certified Beds
46
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
NOTELLAGE CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1976-07-02
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.97609
Reported LPN Staffing Hours per Resident per Day
0.82283
Reported RN Staffing Hours per Resident per Day
0.43370
Reported Licensed Staffing Hours per Resident per Day
1.25652
Reported Total Nurse Staffing Hours per Resident per Day
4.23262
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02065
Expected CNA Staffing Hours per Resident per Day
2.45506
Expected LPN Staffing Hours per Resident per Day
0.62709
Expected RN Staffing Hours per Resident per Day
1.07432
Expected Total Nurse Staffing Hours per Resident per Day
4.15647
Adjusted CNA Staffing Hours per Resident per Day
2.97444
Adjusted LPN Staffing Hours per Resident per Day
1.08908
Adjusted RN Staffing Hours per Resident per Day
0.30164
Adjusted Total Nurse Staffing Hours per Resident per Day
4.10475
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-01-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2012-10-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2011-07-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
46.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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