Berkley West Conv Hosp - Santa Monica Nursing Home
General Information
UPDATEFederal Provider Number
55136
Provider Name
BERKLEY WEST CONV HOSP
Provider Address
1623 ARIZONA AVENUE
SANTA MONICA, CA 90404
SANTA MONICA, CA 90404
Provider Phone Number
(310) 829-4565
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
54
Number of Residents in Certified Beds
29
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
BERKLEY WEST CONVALESCENT HOSPITAL, INC
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
5
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
2.85345
Reported LPN Staffing Hours per Resident per Day
0.85517
Reported RN Staffing Hours per Resident per Day
1.21379
Reported Licensed Staffing Hours per Resident per Day
2.06897
Reported Total Nurse Staffing Hours per Resident per Day
4.92241
Reported Physical Therapist Staffing Hours per Resident Per Day
0.18966
Expected CNA Staffing Hours per Resident per Day
2.53409
Expected LPN Staffing Hours per Resident per Day
0.65195
Expected RN Staffing Hours per Resident per Day
1.15983
Expected Total Nurse Staffing Hours per Resident per Day
4.34588
Adjusted CNA Staffing Hours per Resident per Day
2.76292
Adjusted LPN Staffing Hours per Resident per Day
1.08872
Adjusted RN Staffing Hours per Resident per Day
0.78196
Adjusted Total Nurse Staffing Hours per Resident per Day
4.56565
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
16
Cycle 1 Standard Survey Health Date
2013-09-29
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
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2012-06-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2011-03-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
20.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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