North Walk Villa Conval. Hosp. - Norwalk Nursing Home
General Information
UPDATEFederal Provider Number
55758
Provider Name
NORTH WALK VILLA CONVAL. HOSP.
Provider Address
12350 ROSECRANS
NORWALK, CA 90650
NORWALK, CA 90650
Provider Phone Number
(562) 921-6624
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
59
Number of Residents in Certified Beds
50
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LIFE CARE CENTERS OF AMERICA, INC.
Date First Approved to Provide Medicare and Medicaid services
1985-10-01
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
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
2.33800
Reported LPN Staffing Hours per Resident per Day
0.77900
Reported RN Staffing Hours per Resident per Day
0.64800
Reported Licensed Staffing Hours per Resident per Day
1.42700
Reported Total Nurse Staffing Hours per Resident per Day
3.76500
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12700
Expected CNA Staffing Hours per Resident per Day
2.54592
Expected LPN Staffing Hours per Resident per Day
0.60837
Expected RN Staffing Hours per Resident per Day
0.98860
Expected Total Nurse Staffing Hours per Resident per Day
4.14288
Adjusted CNA Staffing Hours per Resident per Day
2.25331
Adjusted LPN Staffing Hours per Resident per Day
1.06279
Adjusted RN Staffing Hours per Resident per Day
0.48977
Adjusted Total Nurse Staffing Hours per Resident per Day
3.66323
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2014-04-09
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
21
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
8
Cycle 2 Health Deficiency Score
317
Cycle 2 Standard Health Survey Date
2012-12-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
317
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2011-09-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
145.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
4
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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