Olive Vista Behavioral Health Center - Pomona Nursing Home
General Information
UPDATEFederal Provider Number
05A164
Provider Name
OLIVE VISTA BEHAVIORAL HEALTH CENTER
Provider Address
2335 S TOWNE AVENUE
POMONA, CA 91766
POMONA, CA 91766
Provider Phone Number
(909) 628-6024
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
120
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
1974-03-31
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
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
1.65750
Reported LPN Staffing Hours per Resident per Day
0.59042
Reported RN Staffing Hours per Resident per Day
0.35875
Reported Licensed Staffing Hours per Resident per Day
0.94917
Reported Total Nurse Staffing Hours per Resident per Day
2.60667
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
1.27371
Expected LPN Staffing Hours per Resident per Day
0.44359
Expected RN Staffing Hours per Resident per Day
0.58132
Expected Total Nurse Staffing Hours per Resident per Day
2.29862
Adjusted CNA Staffing Hours per Resident per Day
3.19305
Adjusted LPN Staffing Hours per Resident per Day
1.10473
Adjusted RN Staffing Hours per Resident per Day
0.46112
Adjusted Total Nurse Staffing Hours per Resident per Day
4.57110
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-07-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
108
Cycle 2 Standard Health Survey Date
2013-04-01
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
108
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-08-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
56.66700
Number of Facility Reported Incidents
86
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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