Intercommunity Healthcare & Rehabilitation Center - Norwalk Nursing Home
General Information
UPDATEFederal Provider Number
55457
Provider Name
INTERCOMMUNITY HEALTHCARE & REHABILITATION CENTER
Provider Address
12627 STUDEBAKER ROAD
NORWALK, CA 90650
NORWALK, CA 90650
Provider Phone Number
(562) 868-4767
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
86
Number of Residents in Certified Beds
86
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
NORWALK HEALTHCARE, INC.
Date First Approved to Provide Medicare and Medicaid services
1978-02-13
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
4
Health Inspection Rating Footnote
QM Rating
2
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
1.89360
Reported LPN Staffing Hours per Resident per Day
1.74651
Reported RN Staffing Hours per Resident per Day
0.79535
Reported Licensed Staffing Hours per Resident per Day
2.54186
Reported Total Nurse Staffing Hours per Resident per Day
4.43546
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07326
Expected CNA Staffing Hours per Resident per Day
2.51010
Expected LPN Staffing Hours per Resident per Day
0.85511
Expected RN Staffing Hours per Resident per Day
1.30890
Expected Total Nurse Staffing Hours per Resident per Day
4.67411
Adjusted CNA Staffing Hours per Resident per Day
1.85105
Adjusted LPN Staffing Hours per Resident per Day
1.69523
Adjusted RN Staffing Hours per Resident per Day
0.45403
Adjusted Total Nurse Staffing Hours per Resident per Day
3.82509
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2015-04-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
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
36
Cycle 2 Standard Health Survey Date
2014-01-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-09-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
37.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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