Bonnie Brae Convalescent Hosp - Los Angeles Nursing Home
General Information
UPDATEFederal Provider Number
55538
Provider Name
BONNIE BRAE CONVALESCENT HOSP
Provider Address
420 SOUTH BONNIE BRAE ST.
LOS ANGELES, CA 90057
LOS ANGELES, CA 90057
Provider Phone Number
(213) 483-8144
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
59
Number of Residents in Certified Beds
49
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BONNIE BRAE 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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
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
3.23571
Reported LPN Staffing Hours per Resident per Day
0.74694
Reported RN Staffing Hours per Resident per Day
0.63061
Reported Licensed Staffing Hours per Resident per Day
1.37755
Reported Total Nurse Staffing Hours per Resident per Day
4.61326
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03673
Expected CNA Staffing Hours per Resident per Day
2.27366
Expected LPN Staffing Hours per Resident per Day
0.57793
Expected RN Staffing Hours per Resident per Day
0.89667
Expected Total Nurse Staffing Hours per Resident per Day
3.74826
Adjusted CNA Staffing Hours per Resident per Day
3.49194
Adjusted LPN Staffing Hours per Resident per Day
1.07272
Adjusted RN Staffing Hours per Resident per Day
0.52549
Adjusted Total Nurse Staffing Hours per Resident per Day
4.96112
Cycle 1 Total Number of Health Deficiencies
26
Cycle 1 Number of Standard Health Deficiencies
26
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
192
Cycle 1 Standard Survey Health Date
2015-01-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
192
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2013-09-23
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
68
Cycle 3 Total Number of Health Deficiencies
29
Cycle 3 Number of Standard Health Deficiencies
28
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
248
Cycle 3 Standard Health Survey Date
2012-06-22
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
124
Cycle 3 Total Health Score
372
Total Weighted Health Survey Score
180.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
3
Total Amount of Fines in Dollars
4000
Number of Payment Denials
0
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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