Berkley East Convalescent Hosp - Santa Monica Nursing Home
General Information
UPDATEFederal Provider Number
555748
Provider Name
BERKLEY EAST CONVALESCENT HOSP
Provider Address
2021 ARIZONA AVE
SANTA MONICA, CA 90404
SANTA MONICA, CA 90404
Provider Phone Number
(310) 829-5377
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
207
Number of Residents in Certified Beds
84
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
ARIZONA & 21ST CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1999-10-21
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
4.47679
Reported LPN Staffing Hours per Resident per Day
1.70357
Reported RN Staffing Hours per Resident per Day
1.39762
Reported Licensed Staffing Hours per Resident per Day
3.10119
Reported Total Nurse Staffing Hours per Resident per Day
7.57798
Reported Physical Therapist Staffing Hours per Resident Per Day
0.27381
Expected CNA Staffing Hours per Resident per Day
2.39960
Expected LPN Staffing Hours per Resident per Day
0.75601
Expected RN Staffing Hours per Resident per Day
1.53993
Expected Total Nurse Staffing Hours per Resident per Day
4.69555
Adjusted CNA Staffing Hours per Resident per Day
4.57772
Adjusted LPN Staffing Hours per Resident per Day
1.87029
Adjusted RN Staffing Hours per Resident per Day
0.67815
Adjusted Total Nurse Staffing Hours per Resident per Day
6.50533
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
2015-03-29
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
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-12-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-09-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
32.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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