California Nursing Homes >> Avalon Nursing Homes >> Catalina Island Medical Center D/p Snf

Catalina Island Medical Center D/p Snf - Avalon Nursing Home

General Information

UPDATE
Federal Provider Number
555187
Provider Name
CATALINA ISLAND MEDICAL CENTER D/P SNF
Provider Address
100 FALLS CANYON RD
AVALON, CA 90704
Provider Phone Number
3105100700
Provider SSA County
200
Provider County Name
Los Angeles
Ownership Type
Government - City
Number of Certified Beds
6
Number of Residents in Certified Beds
6
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
AVALON MEDICAL DEVELOPMENT CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1985-03-06
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
0
QM Rating Footnote
Data Not Available
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
1.85833
Reported LPN Staffing Hours per Resident per Day
0.95000
Reported RN Staffing Hours per Resident per Day
7.61667
Reported Licensed Staffing Hours per Resident per Day
8.56667
Reported Total Nurse Staffing Hours per Resident per Day
10.42500
Reported Physical Therapist Staffing Hours per Resident Per Day
0.95000
Expected CNA Staffing Hours per Resident per Day
2.20400
Expected LPN Staffing Hours per Resident per Day
0.51833
Expected RN Staffing Hours per Resident per Day
0.66833
Expected Total Nurse Staffing Hours per Resident per Day
3.39067
Adjusted CNA Staffing Hours per Resident per Day
2.06887
Adjusted LPN Staffing Hours per Resident per Day
1.52122
Adjusted RN Staffing Hours per Resident per Day
8.51548
Adjusted Total Nurse Staffing Hours per Resident per Day
12.39347
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
48
Cycle 1 Standard Survey Health Date
2014-10-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
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
64
Cycle 2 Standard Health Survey Date
2013-07-26
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
19
Cycle 3 Number of Standard Health Deficiencies
17
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
120
Cycle 3 Standard Health Survey Date
2012-06-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
120
Total Weighted Health Survey Score
65.33300
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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