Golden State Colonial Healthcare Center - North Hollywood Nursing Home
General Information
UPDATEFederal Provider Number
555011
Provider Name
GOLDEN STATE COLONIAL HEALTHCARE CENTER
Provider Address
10830 OXNARD STREET
NORTH HOLLYWOOD, CA 91606
NORTH HOLLYWOOD, CA 91606
Provider Phone Number
8187638247
Provider SSA County
200
Provider County Name
Los Angeles
Ownership Type
For profit - Corporation
Number of Certified Beds
49
Number of Residents in Certified Beds
48
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FOUR RIVERS MANAGEMENT CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1976-11-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.55000
Reported LPN Staffing Hours per Resident per Day
0.76146
Reported RN Staffing Hours per Resident per Day
0.22604
Reported Licensed Staffing Hours per Resident per Day
0.98750
Reported Total Nurse Staffing Hours per Resident per Day
3.53750
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05938
Expected CNA Staffing Hours per Resident per Day
2.08957
Expected LPN Staffing Hours per Resident per Day
0.57716
Expected RN Staffing Hours per Resident per Day
1.09789
Expected Total Nurse Staffing Hours per Resident per Day
3.76462
Adjusted CNA Staffing Hours per Resident per Day
2.99436
Adjusted LPN Staffing Hours per Resident per Day
1.09504
Adjusted RN Staffing Hours per Resident per Day
0.15384
Adjusted Total Nurse Staffing Hours per Resident per Day
3.78772
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-02-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
16
Cycle 2 Number of Standard Health Deficiencies
16
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
72
Cycle 2 Standard Health Survey Date
2012-11-04
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
13
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2011-08-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
54.00000
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
Nursiong Homes Nearby
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Windsor Gardens Healthcare Of The Valley
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Sherman Village Hcc
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Alameda Care Center
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