Berkley Valley Conv Hospital - Van Nuys Nursing Home
General Information
UPDATEFederal Provider Number
56253
Provider Name
BERKLEY VALLEY CONV HOSPITAL
Provider Address
6600 SEPULVEDA BLVD.
VAN NUYS, CA 91411
VAN NUYS, CA 91411
Provider Phone Number
(818) 786-0020
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
125
Number of Residents in Certified Beds
102
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BERKLEY VALLEY CONVALESCENT HOSPITAL INC
Date First Approved to Provide Medicare and Medicaid services
1971-01-01
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
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
2.55833
Reported LPN Staffing Hours per Resident per Day
0.34755
Reported RN Staffing Hours per Resident per Day
0.64951
Reported Licensed Staffing Hours per Resident per Day
0.99706
Reported Total Nurse Staffing Hours per Resident per Day
3.55539
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05735
Expected CNA Staffing Hours per Resident per Day
2.33708
Expected LPN Staffing Hours per Resident per Day
0.58912
Expected RN Staffing Hours per Resident per Day
0.93891
Expected Total Nurse Staffing Hours per Resident per Day
3.86511
Adjusted CNA Staffing Hours per Resident per Day
2.68599
Adjusted LPN Staffing Hours per Resident per Day
0.48966
Adjusted RN Staffing Hours per Resident per Day
0.51689
Adjusted Total Nurse Staffing Hours per Resident per Day
3.70789
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
16
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
92
Cycle 1 Standard Survey Health Date
2014-07-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
92
Cycle 2 Total Number of Health Deficiencies
17
Cycle 2 Number of Standard Health Deficiencies
16
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
104
Cycle 2 Standard Health Survey Date
2013-03-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
104
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
84
Cycle 3 Standard Health Survey Date
2011-12-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
84
Total Weighted Health Survey Score
94.66700
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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