Montebello Care Center - Montebello Nursing Home
General Information
UPDATEFederal Provider Number
55153
Provider Name
MONTEBELLO CARE CENTER
Provider Address
1035 W BEVERLY BLVD
MONTEBELLO, CA 90640
MONTEBELLO, CA 90640
Provider Phone Number
(213) 724-1315
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
91
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MONTEBELLO CARE CENTER LLC
Date First Approved to Provide Medicare and Medicaid services
1969-04-01
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.67363
Reported LPN Staffing Hours per Resident per Day
0.67747
Reported RN Staffing Hours per Resident per Day
0.59615
Reported Licensed Staffing Hours per Resident per Day
1.27363
Reported Total Nurse Staffing Hours per Resident per Day
2.94725
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10495
Expected CNA Staffing Hours per Resident per Day
2.56384
Expected LPN Staffing Hours per Resident per Day
0.66587
Expected RN Staffing Hours per Resident per Day
1.11171
Expected Total Nurse Staffing Hours per Resident per Day
4.34142
Adjusted CNA Staffing Hours per Resident per Day
1.60173
Adjusted LPN Staffing Hours per Resident per Day
0.84446
Adjusted RN Staffing Hours per Resident per Day
0.40068
Adjusted Total Nurse Staffing Hours per Resident per Day
2.73645
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-08-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
88
Cycle 2 Standard Health Survey Date
2013-04-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
88
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-10-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
72.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
19338
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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