Doctors Hosp Of West Covina - West Covina Nursing Home

General Information

UPDATE
Federal Provider Number
555649
Provider Name
DOCTORS HOSP OF WEST COVINA
Provider Address
725 S. ORANGE AVENUE
WEST COVINA, CA 91790
Provider Phone Number
(818) 338-8481
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
33
Number of Residents in Certified Beds
29
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1995-10-12
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Family
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
3
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
3.28793
Reported LPN Staffing Hours per Resident per Day
2.99828
Reported RN Staffing Hours per Resident per Day
1.40517
Reported Licensed Staffing Hours per Resident per Day
4.40345
Reported Total Nurse Staffing Hours per Resident per Day
7.69138
Reported Physical Therapist Staffing Hours per Resident Per Day
0.17414
Expected CNA Staffing Hours per Resident per Day
2.91136
Expected LPN Staffing Hours per Resident per Day
1.38685
Expected RN Staffing Hours per Resident per Day
1.82194
Expected Total Nurse Staffing Hours per Resident per Day
6.12014
Adjusted CNA Staffing Hours per Resident per Day
2.77108
Adjusted LPN Staffing Hours per Resident per Day
1.79441
Adjusted RN Staffing Hours per Resident per Day
0.57628
Adjusted Total Nurse Staffing Hours per Resident per Day
5.06576
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
88
Cycle 1 Standard Survey Health Date
2014-08-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
88
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-05-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
16
Cycle 3 Number of Standard Health Deficiencies
16
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
92
Cycle 3 Standard Health Survey Date
2012-02-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
92
Total Weighted Health Survey Score
67.33300
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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