Imperial Crest Health Care - Hawthorne Nursing Home
General Information
UPDATEFederal Provider Number
555719
Provider Name
IMPERIAL CREST HEALTH CARE
Provider Address
11834 INGLEWOOD AVENUE
HAWTHORNE, CA 90250
HAWTHORNE, CA 90250
Provider Phone Number
(310) 679-1461
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
105
Number of Residents in Certified Beds
92
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1997-10-16
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
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.56196
Reported LPN Staffing Hours per Resident per Day
3.08859
Reported RN Staffing Hours per Resident per Day
1.75435
Reported Licensed Staffing Hours per Resident per Day
4.84293
Reported Total Nurse Staffing Hours per Resident per Day
7.40490
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06196
Expected CNA Staffing Hours per Resident per Day
2.34064
Expected LPN Staffing Hours per Resident per Day
0.85552
Expected RN Staffing Hours per Resident per Day
1.30131
Expected Total Nurse Staffing Hours per Resident per Day
4.49748
Adjusted CNA Staffing Hours per Resident per Day
2.68571
Adjusted LPN Staffing Hours per Resident per Day
2.99644
Adjusted RN Staffing Hours per Resident per Day
1.00733
Adjusted Total Nurse Staffing Hours per Resident per Day
6.63670
Cycle 1 Total Number of Health Deficiencies
22
Cycle 1 Number of Standard Health Deficiencies
22
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
124
Cycle 1 Standard Survey Health Date
2014-02-02
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
62
Cycle 1 Total Health Score
186
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
14
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
88
Cycle 2 Standard Health Survey Date
2012-10-31
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
88
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2011-07-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
129.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
1
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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