Live Oak Rehab Center - San Gabriel Nursing Home
General Information
UPDATEFederal Provider Number
56127
Provider Name
LIVE OAK REHAB CENTER
Provider Address
537 W LIVE OAK
SAN GABRIEL, CA 91776
SAN GABRIEL, CA 91776
Provider Phone Number
(626) 289-3763
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
97
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SGV HEALTHCARE INC
Date First Approved to Provide Medicare and Medicaid services
1974-06-01
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
1
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
2.01649
Reported LPN Staffing Hours per Resident per Day
0.71907
Reported RN Staffing Hours per Resident per Day
0.41495
Reported Licensed Staffing Hours per Resident per Day
1.13402
Reported Total Nurse Staffing Hours per Resident per Day
3.15051
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11392
Expected CNA Staffing Hours per Resident per Day
2.47063
Expected LPN Staffing Hours per Resident per Day
0.60993
Expected RN Staffing Hours per Resident per Day
1.02328
Expected Total Nurse Staffing Hours per Resident per Day
4.10384
Adjusted CNA Staffing Hours per Resident per Day
2.00267
Adjusted LPN Staffing Hours per Resident per Day
0.97852
Adjusted RN Staffing Hours per Resident per Day
0.30300
Adjusted Total Nurse Staffing Hours per Resident per Day
3.09451
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
84
Cycle 1 Standard Survey Health Date
2015-03-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
84
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-11-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
16
Cycle 3 Number of Standard Health Deficiencies
16
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
96
Cycle 3 Standard Health Survey Date
2012-08-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
96
Total Weighted Health Survey Score
64.66700
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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