Keiro Intermediate Care - Los Angeles Nursing Home
General Information
UPDATEFederal Provider Number
05A411
Provider Name
KEIRO INTERMEDIATE CARE
Provider Address
325 SOUTH BOYLE AVE
LOS ANGELES, CA 90033
LOS ANGELES, CA 90033
Provider Phone Number
(323) 980-7533
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
90
Number of Residents in Certified Beds
90
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1999-10-29
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
5
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
1.45222
Reported LPN Staffing Hours per Resident per Day
0.52444
Reported RN Staffing Hours per Resident per Day
0.29167
Reported Licensed Staffing Hours per Resident per Day
0.81611
Reported Total Nurse Staffing Hours per Resident per Day
2.26833
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00500
Expected CNA Staffing Hours per Resident per Day
1.64044
Expected LPN Staffing Hours per Resident per Day
0.49847
Expected RN Staffing Hours per Resident per Day
0.55556
Expected Total Nurse Staffing Hours per Resident per Day
2.69446
Adjusted CNA Staffing Hours per Resident per Day
2.17217
Adjusted LPN Staffing Hours per Resident per Day
0.87325
Adjusted RN Staffing Hours per Resident per Day
0.39228
Adjusted Total Nurse Staffing Hours per Resident per Day
3.39341
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-09-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-05-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-02-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
16.00000
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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