Country Villa Westwood - Los Angeles Nursing Home
General Information
UPDATEFederal Provider Number
55060
Provider Name
COUNTRY VILLA WESTWOOD
Provider Address
12121 SANTA MONICA BOULEVARD
LOS ANGELES, CA 90025
LOS ANGELES, CA 90025
Provider Phone Number
3108260821
Provider SSA County
200
Provider County Name
Los Angeles
Ownership Type
For profit - Corporation
Number of Certified Beds
93
Number of Residents in Certified Beds
82
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTRY VILLA WESTWOOD, A CA LTD
Date First Approved to Provide Medicare and Medicaid services
1980-07-01
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
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
2.02500
Reported LPN Staffing Hours per Resident per Day
1.02439
Reported RN Staffing Hours per Resident per Day
0.52622
Reported Licensed Staffing Hours per Resident per Day
1.55061
Reported Total Nurse Staffing Hours per Resident per Day
3.57561
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06951
Expected CNA Staffing Hours per Resident per Day
2.44305
Expected LPN Staffing Hours per Resident per Day
0.61071
Expected RN Staffing Hours per Resident per Day
1.08700
Expected Total Nurse Staffing Hours per Resident per Day
4.14076
Adjusted CNA Staffing Hours per Resident per Day
2.03383
Adjusted LPN Staffing Hours per Resident per Day
1.39221
Adjusted RN Staffing Hours per Resident per Day
0.36172
Adjusted Total Nurse Staffing Hours per Resident per Day
3.48075
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-11-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-08-01
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
19
Cycle 3 Number of Standard Health Deficiencies
18
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
112
Cycle 3 Standard Health Survey Date
2012-05-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
112
Total Weighted Health Survey Score
60.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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Berkley East Convalescent Hosp
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Santa Monica Health Care Cente
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The Rehabilitation Center Of Santa Monica
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SANTA MONICA CA 90404 | 1.2 miles away
Pacific Convalescent Center
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SANTA MONICA CA 90404 | 1.4 miles away
Seaport 17th Care Center
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Berkley West Conv Hosp
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Goldstar Rehabilitation & Nsg Ctr Of Santa Monica
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Fireside Convalescent Hospital
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