Pacific Convalescent Center - Santa Monica Nursing Home
General Information
UPDATEFederal Provider Number
555054
Provider Name
PACIFIC CONVALESCENT CENTER
Provider Address
1323 17TH STREET
SANTA MONICA, CA 90404
SANTA MONICA, CA 90404
Provider Phone Number
(310) 453-5456
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
49
Number of Residents in Certified Beds
46
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PC CARE LLC
Date First Approved to Provide Medicare and Medicaid services
1977-03-10
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
0.25543
Reported LPN Staffing Hours per Resident per Day
0.60870
Reported RN Staffing Hours per Resident per Day
1.12391
Reported Licensed Staffing Hours per Resident per Day
1.73261
Reported Total Nurse Staffing Hours per Resident per Day
1.98804
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12391
Expected CNA Staffing Hours per Resident per Day
2.40388
Expected LPN Staffing Hours per Resident per Day
0.69123
Expected RN Staffing Hours per Resident per Day
1.12080
Expected Total Nurse Staffing Hours per Resident per Day
4.21591
Adjusted CNA Staffing Hours per Resident per Day
0.26072
Adjusted LPN Staffing Hours per Resident per Day
0.73090
Adjusted RN Staffing Hours per Resident per Day
0.74927
Adjusted Total Nurse Staffing Hours per Resident per Day
1.90080
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-06-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-02-09
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2011-11-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
20.66700
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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