Camellia Gardens Care Center - Pasadena Nursing Home
General Information
UPDATEFederal Provider Number
56316
Provider Name
CAMELLIA GARDENS CARE CENTER
Provider Address
1920 N. FAIR OAKS AVENUE
PASADENA, CA 91103
PASADENA, CA 91103
Provider Phone Number
(626) 798-6777
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
80
Number of Residents in Certified Beds
69
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ARPOM, INC
Date First Approved to Provide Medicare and Medicaid services
1974-07-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
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
2.46594
Reported LPN Staffing Hours per Resident per Day
1.47826
Reported RN Staffing Hours per Resident per Day
1.38768
Reported Licensed Staffing Hours per Resident per Day
2.86594
Reported Total Nurse Staffing Hours per Resident per Day
5.33188
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02101
Expected CNA Staffing Hours per Resident per Day
2.50277
Expected LPN Staffing Hours per Resident per Day
0.90836
Expected RN Staffing Hours per Resident per Day
1.34247
Expected Total Nurse Staffing Hours per Resident per Day
4.75360
Adjusted CNA Staffing Hours per Resident per Day
2.41759
Adjusted LPN Staffing Hours per Resident per Day
1.35074
Adjusted RN Staffing Hours per Resident per Day
0.77236
Adjusted Total Nurse Staffing Hours per Resident per Day
4.52126
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2014-03-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2012-11-15
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
56
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
72
Cycle 3 Standard Health Survey Date
2011-08-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
62.66700
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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