Intercommunity Care Center - Long Beach Nursing Home
General Information
UPDATEFederal Provider Number
555823
Provider Name
INTERCOMMUNITY CARE CENTER
Provider Address
2626 GRAND AVENUE
LONG BEACH, CA 90815
LONG BEACH, CA 90815
Provider Phone Number
(562) 427-8915
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
147
Number of Residents in Certified Beds
142
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
INTERCOMMUNITY CARE CENTERS, INC.
Date First Approved to Provide Medicare and Medicaid services
2005-03-27
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
5
QM Rating Footnote
Staffing Rating
3
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
2.65176
Reported LPN Staffing Hours per Resident per Day
0.72430
Reported RN Staffing Hours per Resident per Day
0.34683
Reported Licensed Staffing Hours per Resident per Day
1.07113
Reported Total Nurse Staffing Hours per Resident per Day
3.72289
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.00547
Expected LPN Staffing Hours per Resident per Day
0.53065
Expected RN Staffing Hours per Resident per Day
0.69078
Expected Total Nurse Staffing Hours per Resident per Day
3.22691
Adjusted CNA Staffing Hours per Resident per Day
3.24443
Adjusted LPN Staffing Hours per Resident per Day
1.13288
Adjusted RN Staffing Hours per Resident per Day
0.37516
Adjusted Total Nurse Staffing Hours per Resident per Day
4.65046
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
159
Cycle 1 Standard Survey Health Date
2013-07-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
159
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
2012-03-20
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
15
Cycle 3 Number of Standard Health Deficiencies
14
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2010-12-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
106.83300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
2
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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