Hollywood Presbyterian Medical Center D/p Snf - Los Angeles Nursing Home
General Information
UPDATEFederal Provider Number
56311
Provider Name
HOLLYWOOD PRESBYTERIAN MEDICAL CENTER D/P SNF
Provider Address
4636 FOUNTAIN AVENUE
LOS ANGELES, CA 90029
LOS ANGELES, CA 90029
Provider Phone Number
(323) 913-4830
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
89
Number of Residents in Certified Beds
69
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
CHA HOLLYWOOD MEDICAL CENTER LP
Date First Approved to Provide Medicare and Medicaid services
1971-08-03
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
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
4.30652
Reported LPN Staffing Hours per Resident per Day
3.91304
Reported RN Staffing Hours per Resident per Day
1.46159
Reported Licensed Staffing Hours per Resident per Day
5.37464
Reported Total Nurse Staffing Hours per Resident per Day
9.68115
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01014
Expected CNA Staffing Hours per Resident per Day
2.81172
Expected LPN Staffing Hours per Resident per Day
1.45098
Expected RN Staffing Hours per Resident per Day
1.89209
Expected Total Nurse Staffing Hours per Resident per Day
6.15479
Adjusted CNA Staffing Hours per Resident per Day
3.75816
Adjusted LPN Staffing Hours per Resident per Day
2.23837
Adjusted RN Staffing Hours per Resident per Day
0.57719
Adjusted Total Nurse Staffing Hours per Resident per Day
6.34039
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-04-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-01-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
52
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2011-10-17
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
22
Cycle 3 Total Health Score
66
Total Weighted Health Survey Score
48.33300
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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