Laurel Convalescent Hospital - Fontana Nursing Home
General Information
UPDATEFederal Provider Number
56429
Provider Name
LAUREL CONVALESCENT HOSPITAL
Provider Address
7509 N LAUREL AVE
FONTANA, CA 92336
FONTANA, CA 92336
Provider Phone Number
(909) 822-8066
Provider SSA County
460
Provider County Name
San Bernardino
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
95
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LAUREL WELLNESS AND NURSING CENTER LLC
Date First Approved to Provide Medicare and Medicaid services
1974-03-15
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
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
2
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
2.39000
Reported LPN Staffing Hours per Resident per Day
0.91421
Reported RN Staffing Hours per Resident per Day
0.51316
Reported Licensed Staffing Hours per Resident per Day
1.42737
Reported Total Nurse Staffing Hours per Resident per Day
3.81737
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09684
Expected CNA Staffing Hours per Resident per Day
2.42800
Expected LPN Staffing Hours per Resident per Day
0.68270
Expected RN Staffing Hours per Resident per Day
1.13636
Expected Total Nurse Staffing Hours per Resident per Day
4.24706
Adjusted CNA Staffing Hours per Resident per Day
2.41530
Adjusted LPN Staffing Hours per Resident per Day
1.11146
Adjusted RN Staffing Hours per Resident per Day
0.33742
Adjusted Total Nurse Staffing Hours per Resident per Day
3.62308
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2015-04-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
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
32
Cycle 2 Standard Health Survey Date
2014-05-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
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
40
Cycle 3 Standard Health Survey Date
2013-06-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
49.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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