High Valley Lodge - Sunland Nursing Home
General Information
UPDATEFederal Provider Number
55856
Provider Name
HIGH VALLEY LODGE
Provider Address
7912 TOPLEY LANE
SUNLAND, CA 91040
SUNLAND, CA 91040
Provider Phone Number
8183523158
Provider SSA County
200
Provider County Name
Los Angeles
Ownership Type
For profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
48
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PRN CONVALESCENT HOSPITAL INC
Date First Approved to Provide Medicare and Medicaid services
1979-05-01
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
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
2.72396
Reported LPN Staffing Hours per Resident per Day
0.96875
Reported RN Staffing Hours per Resident per Day
0.17708
Reported Licensed Staffing Hours per Resident per Day
1.14583
Reported Total Nurse Staffing Hours per Resident per Day
3.86979
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01458
Expected CNA Staffing Hours per Resident per Day
2.34006
Expected LPN Staffing Hours per Resident per Day
0.50801
Expected RN Staffing Hours per Resident per Day
0.71345
Expected Total Nurse Staffing Hours per Resident per Day
3.56152
Adjusted CNA Staffing Hours per Resident per Day
2.85625
Adjusted LPN Staffing Hours per Resident per Day
1.58277
Adjusted RN Staffing Hours per Resident per Day
0.18546
Adjusted Total Nurse Staffing Hours per Resident per Day
4.37980
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
16
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
132
Cycle 1 Standard Survey Health Date
2015-01-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
132
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
32
Cycle 2 Standard Health Survey Date
2013-09-28
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
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2012-06-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
87.33300
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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