Lakewood Manor North - Los Angeles Nursing Home
General Information
UPDATEFederal Provider Number
56078
Provider Name
LAKEWOOD MANOR NORTH
Provider Address
831 S LAKE STREET
LOS ANGELES, CA 90057
LOS ANGELES, CA 90057
Provider Phone Number
(213) 380-9175
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
87
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
1969-06-04
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.08793
Reported LPN Staffing Hours per Resident per Day
0.82586
Reported RN Staffing Hours per Resident per Day
0.18793
Reported Licensed Staffing Hours per Resident per Day
1.01379
Reported Total Nurse Staffing Hours per Resident per Day
4.10172
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02471
Expected CNA Staffing Hours per Resident per Day
1.99708
Expected LPN Staffing Hours per Resident per Day
0.52760
Expected RN Staffing Hours per Resident per Day
0.69100
Expected Total Nurse Staffing Hours per Resident per Day
3.21568
Adjusted CNA Staffing Hours per Resident per Day
3.79396
Adjusted LPN Staffing Hours per Resident per Day
1.29920
Adjusted RN Staffing Hours per Resident per Day
0.20322
Adjusted Total Nurse Staffing Hours per Resident per Day
5.14156
Cycle 1 Total Number of Health Deficiencies
18
Cycle 1 Number of Standard Health Deficiencies
18
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
96
Cycle 1 Standard Survey Health Date
2013-09-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
96
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
76
Cycle 2 Standard Health Survey Date
2012-07-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
76
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
15
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
120
Cycle 3 Standard Health Survey Date
2011-11-12
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
60
Cycle 3 Total Health Score
180
Total Weighted Health Survey Score
103.33300
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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