Holiday Manor Care Center - Canoga Park Nursing Home
General Information
UPDATEFederal Provider Number
555578
Provider Name
HOLIDAY MANOR CARE CENTER
Provider Address
20554 ROSCOE BLVD
CANOGA PARK, CA 91306
CANOGA PARK, CA 91306
Provider Phone Number
(818) 341-9800
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
94
Number of Residents in Certified Beds
93
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SELA HEALTHCARE INC
Date First Approved to Provide Medicare and Medicaid services
1993-10-14
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.74355
Reported LPN Staffing Hours per Resident per Day
0.46882
Reported RN Staffing Hours per Resident per Day
0.41935
Reported Licensed Staffing Hours per Resident per Day
0.88817
Reported Total Nurse Staffing Hours per Resident per Day
3.63172
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07312
Expected CNA Staffing Hours per Resident per Day
2.49034
Expected LPN Staffing Hours per Resident per Day
0.56595
Expected RN Staffing Hours per Resident per Day
0.81763
Expected Total Nurse Staffing Hours per Resident per Day
3.87392
Adjusted CNA Staffing Hours per Resident per Day
2.70319
Adjusted LPN Staffing Hours per Resident per Day
0.68755
Adjusted RN Staffing Hours per Resident per Day
0.38323
Adjusted Total Nurse Staffing Hours per Resident per Day
3.77889
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-09-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-05-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2012-02-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
33.33300
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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