Fireside Convalescent Hospital - Santa Monica Nursing Home
General Information
UPDATEFederal Provider Number
555039
Provider Name
FIRESIDE CONVALESCENT HOSPITAL
Provider Address
947 THIRD STREET
SANTA MONICA, CA 90403
SANTA MONICA, CA 90403
Provider Phone Number
(310) 393-7117
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
63
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
F.C.H. INC.
Date First Approved to Provide Medicare and Medicaid services
1977-01-01
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
4
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
2.78016
Reported LPN Staffing Hours per Resident per Day
1.09444
Reported RN Staffing Hours per Resident per Day
0.99127
Reported Licensed Staffing Hours per Resident per Day
2.08571
Reported Total Nurse Staffing Hours per Resident per Day
4.86587
Reported Physical Therapist Staffing Hours per Resident Per Day
0.43095
Expected CNA Staffing Hours per Resident per Day
2.48936
Expected LPN Staffing Hours per Resident per Day
0.68708
Expected RN Staffing Hours per Resident per Day
1.33442
Expected Total Nurse Staffing Hours per Resident per Day
4.51085
Adjusted CNA Staffing Hours per Resident per Day
2.74034
Adjusted LPN Staffing Hours per Resident per Day
1.32210
Adjusted RN Staffing Hours per Resident per Day
0.55506
Adjusted Total Nurse Staffing Hours per Resident per Day
4.34815
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
92
Cycle 1 Standard Survey Health Date
2014-08-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
92
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-04-21
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
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2012-01-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
60.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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