California Convalescent Ctr 1 - Los Angeles Nursing Home
General Information
UPDATEFederal Provider Number
55461
Provider Name
CALIFORNIA CONVALESCENT CTR 1
Provider Address
909 S LAKE STREET
LOS ANGELES, CA 90006
LOS ANGELES, CA 90006
Provider Phone Number
(213) 385-7301
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
66
Number of Residents in Certified Beds
61
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CALIFORNIA CONVALESCENT CENTER 1 INC
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
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
3
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
2.98443
Reported LPN Staffing Hours per Resident per Day
0.77787
Reported RN Staffing Hours per Resident per Day
0.28115
Reported Licensed Staffing Hours per Resident per Day
1.05902
Reported Total Nurse Staffing Hours per Resident per Day
4.04345
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02951
Expected CNA Staffing Hours per Resident per Day
1.92832
Expected LPN Staffing Hours per Resident per Day
0.50816
Expected RN Staffing Hours per Resident per Day
0.69239
Expected Total Nurse Staffing Hours per Resident per Day
3.12887
Adjusted CNA Staffing Hours per Resident per Day
3.79755
Adjusted LPN Staffing Hours per Resident per Day
1.27052
Adjusted RN Staffing Hours per Resident per Day
0.30341
Adjusted Total Nurse Staffing Hours per Resident per Day
5.20914
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
60
Cycle 1 Standard Survey Health Date
2014-08-17
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
30
Cycle 1 Total Health Score
90
Cycle 2 Total Number of Health Deficiencies
24
Cycle 2 Number of Standard Health Deficiencies
24
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
494
Cycle 2 Standard Health Survey Date
2013-04-24
Cycle 2 Number of Health Revisits
3
Cycle 2 Health Revisit Score
346
Cycle 2 Total Health Score
840
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
88
Cycle 3 Standard Health Survey Date
2012-07-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
88
Total Weighted Health Survey Score
339.66700
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
1
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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