Laurel Park Behavioral Health Center - Pomona Nursing Home
General Information
UPDATEFederal Provider Number
05A137
Provider Name
LAUREL PARK BEHAVIORAL HEALTH CENTER
Provider Address
1425 LAUREL AVENUE
POMONA, CA 91767
POMONA, CA 91767
Provider Phone Number
(909) 622-1069
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
43
Number of Residents in Certified Beds
42
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
1975-02-01
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
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
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.82143
Reported LPN Staffing Hours per Resident per Day
0.81786
Reported RN Staffing Hours per Resident per Day
0.30000
Reported Licensed Staffing Hours per Resident per Day
1.11786
Reported Total Nurse Staffing Hours per Resident per Day
2.93929
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
1.27120
Expected LPN Staffing Hours per Resident per Day
0.43620
Expected RN Staffing Hours per Resident per Day
0.60651
Expected Total Nurse Staffing Hours per Resident per Day
2.31391
Adjusted CNA Staffing Hours per Resident per Day
3.51576
Adjusted LPN Staffing Hours per Resident per Day
1.55622
Adjusted RN Staffing Hours per Resident per Day
0.36959
Adjusted Total Nurse Staffing Hours per Resident per Day
5.12032
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-10-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-06-18
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
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-03-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
18.00000
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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