Good Shepherd Hlth Care Ctr - Santa Monica Nursing Home
General Information
UPDATEFederal Provider Number
555061
Provider Name
GOOD SHEPHERD HLTH CARE CTR
Provider Address
1131 ARIZONA AVE.
SANTA MONICA, CA 90401
SANTA MONICA, CA 90401
Provider Phone Number
(310) 451-4800
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
48
Number of Residents in Certified Beds
40
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GOOD SHEPHERD HEALTHCARE CENTER OF SANTA MONICA
Date First Approved to Provide Medicare and Medicaid services
1977-03-22
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
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
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
2.54500
Reported LPN Staffing Hours per Resident per Day
1.14250
Reported RN Staffing Hours per Resident per Day
0.66375
Reported Licensed Staffing Hours per Resident per Day
1.80625
Reported Total Nurse Staffing Hours per Resident per Day
4.35125
Reported Physical Therapist Staffing Hours per Resident Per Day
0.17875
Expected CNA Staffing Hours per Resident per Day
2.46988
Expected LPN Staffing Hours per Resident per Day
0.58742
Expected RN Staffing Hours per Resident per Day
0.95337
Expected Total Nurse Staffing Hours per Resident per Day
4.01067
Adjusted CNA Staffing Hours per Resident per Day
2.52832
Adjusted LPN Staffing Hours per Resident per Day
1.61431
Adjusted RN Staffing Hours per Resident per Day
0.52021
Adjusted Total Nurse Staffing Hours per Resident per Day
4.37320
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2015-01-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
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
60
Cycle 2 Standard Health Survey Date
2013-09-22
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
60
Cycle 3 Total Number of Health Deficiencies
17
Cycle 3 Number of Standard Health Deficiencies
16
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
88
Cycle 3 Standard Health Survey Date
2012-06-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
88
Total Weighted Health Survey Score
46.66700
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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