Country Villa Terrace Nrsg Ctr - Los Angeles Nursing Home
General Information
UPDATEFederal Provider Number
55119
Provider Name
COUNTRY VILLA TERRACE NRSG CTR
Provider Address
6070 W. PICO BOULEVARD
LOS ANGELES, CA 90035
LOS ANGELES, CA 90035
Provider Phone Number
3236533980
Provider SSA County
200
Provider County Name
Los Angeles
Ownership Type
For profit - Partnership
Number of Certified Beds
49
Number of Residents in Certified Beds
47
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
1968-07-01
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
5
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
2.45532
Reported LPN Staffing Hours per Resident per Day
2.12766
Reported RN Staffing Hours per Resident per Day
0.52340
Reported Licensed Staffing Hours per Resident per Day
2.65106
Reported Total Nurse Staffing Hours per Resident per Day
5.10638
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12128
Expected CNA Staffing Hours per Resident per Day
2.42922
Expected LPN Staffing Hours per Resident per Day
0.70200
Expected RN Staffing Hours per Resident per Day
1.27507
Expected Total Nurse Staffing Hours per Resident per Day
4.40630
Adjusted CNA Staffing Hours per Resident per Day
2.48006
Adjusted LPN Staffing Hours per Resident per Day
2.51561
Adjusted RN Staffing Hours per Resident per Day
0.30672
Adjusted Total Nurse Staffing Hours per Resident per Day
4.67134
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-05-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-01-27
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
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2011-11-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
17.33300
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
Nursiong Homes Nearby
Flower Villa, Inc
1480 S. La Cienega Bl |
LOS ANGELES CA 90035 | 0.2 mile away
Country Villa Pavilion Nrsg Ct
5916 W. Pico Boulevard |
LOS ANGELES CA 90035 | 0.3 mile away
Westside Health Care
1020 South Fairfax Ave |
LOS ANGELES CA 90019 | 0.6 mile away
The Rehabilitation Centre Of Beverly Hills
580 South San Vicente Blvd. |
LOS ANGELES CA 90048 | 1 mile away
Guardian Rehabilitation Hosp
533 S. Fairfax Ave |
LOS ANGELES CA 90036 | 1.2 miles away
Sharon Care Center
8167 West Third St. |
LOS ANGELES CA 90048 | 1.4 miles away
Longwood Manor Conv.hospital
4853 W. Washington Bl. |
LOS ANGELES CA 90016 | 1.8 miles away
Crenshaw Nursing Home
1900 S Longwood Ave |
LOS ANGELES CA 90016 | 1.8 miles away
Kennedy Post Acute Care Center
619 N. Fairfax Ave |
LOS ANGELES CA 90036 | 2.2 miles away
Southern California Hosp At Culver City D/p Snf
3828 Delmas Terrace |
CULVER CITY CA 90230 | 2.4 miles away
Country Villa Wilshire
855 North Fairfax Avenue |
LOS ANGELES CA 90046 | 2.5 miles away
The Rehabilitation Center On La Brea
505 N. La Brea Avenue |
LOS ANGELES CA 90036 | 2.6 miles away
Windsor Care Center Of Cheviot Hills
3533 Motor Avenue |
LOS ANGELES CA 90034 | 2.7 miles away
Windsor Gardens Conv Hospital
915 S. Crenshaw Blvd. |
LOS ANGELES CA 90019 | 2.9 miles away
Country Villa South Conv Ctr
3515 Overland Avenue |
LOS ANGELES CA 90034 | 2.9 miles away
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