Casa Bonita Convalescent - San Dimas Nursing Home
General Information
UPDATEFederal Provider Number
56291
Provider Name
CASA BONITA CONVALESCENT
Provider Address
535 E BONITA AVENUE
SAN DIMAS, CA 91773
SAN DIMAS, CA 91773
Provider Phone Number
(909) 599-1248
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
106
Number of Residents in Certified Beds
105
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CASA BONITA CONVALESCENT HOSPITAL INC
Date First Approved to Provide Medicare and Medicaid services
1972-04-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
2.32333
Reported LPN Staffing Hours per Resident per Day
1.43667
Reported RN Staffing Hours per Resident per Day
0.60810
Reported Licensed Staffing Hours per Resident per Day
2.04476
Reported Total Nurse Staffing Hours per Resident per Day
4.36810
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05667
Expected CNA Staffing Hours per Resident per Day
2.52278
Expected LPN Staffing Hours per Resident per Day
0.87232
Expected RN Staffing Hours per Resident per Day
1.35679
Expected Total Nurse Staffing Hours per Resident per Day
4.75189
Adjusted CNA Staffing Hours per Resident per Day
2.25971
Adjusted LPN Staffing Hours per Resident per Day
1.36697
Adjusted RN Staffing Hours per Resident per Day
0.33489
Adjusted Total Nurse Staffing Hours per Resident per Day
3.70535
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
72
Cycle 1 Standard Survey Health Date
2014-03-27
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
36
Cycle 1 Total Health Score
108
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2012-11-30
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
19
Cycle 3 Number of Standard Health Deficiencies
18
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
200
Cycle 3 Standard Health Survey Date
2011-09-01
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
100
Cycle 3 Total Health Score
300
Total Weighted Health Survey Score
126.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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