Mary Health Of The Sick Convalescent & Nursing Hos - Newbury Park Nursing Home
General Information
UPDATEFederal Provider Number
55022
Provider Name
MARY HEALTH OF THE SICK CONVALESCENT & NURSING HOS
Provider Address
2929 THERESA DR
NEWBURY PARK, CA 91320
NEWBURY PARK, CA 91320
Provider Phone Number
8054983644
Provider SSA County
660
Provider County Name
Ventura
Ownership Type
Non profit - Corporation
Number of Certified Beds
61
Number of Residents in Certified Beds
61
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MARY HEALTH OF THE SICK CONVALESCENT AND NURSING HOSPITAL INCORPORATED
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.18934
Reported LPN Staffing Hours per Resident per Day
0.45410
Reported RN Staffing Hours per Resident per Day
0.94344
Reported Licensed Staffing Hours per Resident per Day
1.39754
Reported Total Nurse Staffing Hours per Resident per Day
4.58688
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05820
Expected CNA Staffing Hours per Resident per Day
2.62165
Expected LPN Staffing Hours per Resident per Day
0.68434
Expected RN Staffing Hours per Resident per Day
0.99603
Expected Total Nurse Staffing Hours per Resident per Day
4.30201
Adjusted CNA Staffing Hours per Resident per Day
2.98503
Adjusted LPN Staffing Hours per Resident per Day
0.55076
Adjusted RN Staffing Hours per Resident per Day
0.70775
Adjusted Total Nurse Staffing Hours per Resident per Day
4.29781
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
95
Cycle 1 Standard Survey Health Date
2014-11-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
95
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-10-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-11-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
50.83300
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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