Harbor View House - San Pedro Nursing Home
General Information
UPDATEFederal Provider Number
500000000000000000000000000000
Provider Name
HARBOR VIEW HOUSE
Provider Address
921 S. BEACON STREET
SAN PEDRO, CA 90731
SAN PEDRO, CA 90731
Provider Phone Number
(310) 547-3341
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
83
Number of Residents in Certified Beds
80
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1974-03-31
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
Partial
Rating Detail Information
Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
0.80875
Reported LPN Staffing Hours per Resident per Day
0.69063
Reported RN Staffing Hours per Resident per Day
0.25188
Reported Licensed Staffing Hours per Resident per Day
0.94250
Reported Total Nurse Staffing Hours per Resident per Day
1.75126
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
1.23489
Expected LPN Staffing Hours per Resident per Day
0.45101
Expected RN Staffing Hours per Resident per Day
0.52531
Expected Total Nurse Staffing Hours per Resident per Day
2.21121
Adjusted CNA Staffing Hours per Resident per Day
1.60697
Adjusted LPN Staffing Hours per Resident per Day
1.27098
Adjusted RN Staffing Hours per Resident per Day
0.35828
Adjusted Total Nurse Staffing Hours per Resident per Day
3.19244
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
64
Cycle 1 Standard Survey Health Date
2014-02-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2012-11-18
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2011-08-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
50.66700
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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