Country Villa Pavilion Nrsg Ct - Los Angeles Nursing Home
General Information
UPDATEFederal Provider Number
55160
Provider Name
COUNTRY VILLA PAVILION NRSG CT
Provider Address
5916 W. PICO BOULEVARD
LOS ANGELES, CA 90035
LOS ANGELES, CA 90035
Provider Phone Number
3239393184
Provider SSA County
200
Provider County Name
Los Angeles
Ownership Type
For profit - Corporation
Number of Certified Beds
59
Number of Residents in Certified Beds
53
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTRY VILLA EAST, L.P.
Date First Approved to Provide Medicare and Medicaid services
1967-09-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.42453
Reported LPN Staffing Hours per Resident per Day
0.76132
Reported RN Staffing Hours per Resident per Day
1.39245
Reported Licensed Staffing Hours per Resident per Day
2.15377
Reported Total Nurse Staffing Hours per Resident per Day
4.57830
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11887
Expected CNA Staffing Hours per Resident per Day
2.51282
Expected LPN Staffing Hours per Resident per Day
0.73280
Expected RN Staffing Hours per Resident per Day
1.21373
Expected Total Nurse Staffing Hours per Resident per Day
4.45936
Adjusted CNA Staffing Hours per Resident per Day
2.36748
Adjusted LPN Staffing Hours per Resident per Day
0.86230
Adjusted RN Staffing Hours per Resident per Day
0.85722
Adjusted Total Nurse Staffing Hours per Resident per Day
4.13842
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
16
Cycle 1 Standard Survey Health Date
2015-02-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
16
Cycle 2 Number of Standard Health Deficiencies
14
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
76
Cycle 2 Standard Health Survey Date
2013-10-20
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
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-07-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
36.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
9
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
Nursiong Homes Nearby
Country Villa Terrace Nrsg Ctr
6070 W. Pico Boulevard |
LOS ANGELES CA 90035 | 0.3 mile away
Flower Villa, Inc
1480 S. La Cienega Bl |
LOS ANGELES CA 90035 | 0.4 mile away
Westside Health Care
1020 South Fairfax Ave |
LOS ANGELES CA 90019 | 0.5 mile away
The Rehabilitation Centre Of Beverly Hills
580 South San Vicente Blvd. |
LOS ANGELES CA 90048 | 1.1 miles away
Guardian Rehabilitation Hosp
533 S. Fairfax Ave |
LOS ANGELES CA 90036 | 1.1 miles away
Sharon Care Center
8167 West Third St. |
LOS ANGELES CA 90048 | 1.5 miles away
Longwood Manor Conv.hospital
4853 W. Washington Bl. |
LOS ANGELES CA 90016 | 1.5 miles away
Crenshaw Nursing Home
1900 S Longwood Ave |
LOS ANGELES CA 90016 | 1.6 miles away
Kennedy Post Acute Care Center
619 N. Fairfax Ave |
LOS ANGELES CA 90036 | 2.2 miles away
The Rehabilitation Center On La Brea
505 N. La Brea Avenue |
LOS ANGELES CA 90036 | 2.4 miles away
Country Villa Wilshire
855 North Fairfax Avenue |
LOS ANGELES CA 90046 | 2.5 miles away
Southern California Hosp At Culver City D/p Snf
3828 Delmas Terrace |
CULVER CITY CA 90230 | 2.6 miles away
Windsor Gardens Conv Hospital
915 S. Crenshaw Blvd. |
LOS ANGELES CA 90019 | 2.6 miles away
Windsor Care Center Of Cheviot Hills
3533 Motor Avenue |
LOS ANGELES CA 90034 | 2.9 miles away
Alcott Rehabilitation Hospital
3551 West Olympic Blvd. |
LOS ANGELES CA 90019 | 2.9 miles away
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