Goldstar Rehabilitation & Nsg Ctr Of Santa Monica - Santa Monica Nursing Home
General Information
UPDATEFederal Provider Number
56334
Provider Name
GOLDSTAR REHABILITATION & NSG CTR OF SANTA MONICA
Provider Address
1340 15TH STREET
SANTA MONICA, CA 90404
SANTA MONICA, CA 90404
Provider Phone Number
(310) 451-9706
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
227
Number of Residents in Certified Beds
178
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GOLDSTAR HEALTHCARE CENTER OF SANTA MONICA, LLC
Date First Approved to Provide Medicare and Medicaid services
1972-07-14
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
3
QM Rating Footnote
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
2.86685
Reported LPN Staffing Hours per Resident per Day
1.54213
Reported RN Staffing Hours per Resident per Day
1.15421
Reported Licensed Staffing Hours per Resident per Day
2.69635
Reported Total Nurse Staffing Hours per Resident per Day
5.56319
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06264
Expected CNA Staffing Hours per Resident per Day
2.57677
Expected LPN Staffing Hours per Resident per Day
0.78592
Expected RN Staffing Hours per Resident per Day
1.15476
Expected Total Nurse Staffing Hours per Resident per Day
4.51745
Adjusted CNA Staffing Hours per Resident per Day
2.72992
Adjusted LPN Staffing Hours per Resident per Day
1.62863
Adjusted RN Staffing Hours per Resident per Day
0.74684
Adjusted Total Nurse Staffing Hours per Resident per Day
4.96401
Cycle 1 Total Number of Health Deficiencies
23
Cycle 1 Number of Standard Health Deficiencies
20
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
120
Cycle 1 Standard Survey Health Date
2014-01-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
120
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
56
Cycle 2 Standard Health Survey Date
2012-10-17
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
56
Cycle 3 Total Number of Health Deficiencies
24
Cycle 3 Number of Standard Health Deficiencies
20
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
144
Cycle 3 Standard Health Survey Date
2011-07-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
144
Total Weighted Health Survey Score
102.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
14
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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