Pilgrim Place Hsc - Claremont Nursing Home
General Information
UPDATEFederal Provider Number
55261
Provider Name
PILGRIM PLACE HSC
Provider Address
721 W HARRISON ST
CLAREMONT, CA 91711
CLAREMONT, CA 91711
Provider Phone Number
(909) 399-5549
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
62
Number of Residents in Certified Beds
55
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PILGRIM PLACE IN CLAREMONT
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
Continuing Care Retirement Community
Y
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
3
Health Inspection Rating Footnote
QM Rating
5
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
3.28818
Reported LPN Staffing Hours per Resident per Day
1.33636
Reported RN Staffing Hours per Resident per Day
0.70091
Reported Licensed Staffing Hours per Resident per Day
2.03727
Reported Total Nurse Staffing Hours per Resident per Day
5.32545
Reported Physical Therapist Staffing Hours per Resident Per Day
0.20000
Expected CNA Staffing Hours per Resident per Day
2.67798
Expected LPN Staffing Hours per Resident per Day
0.63598
Expected RN Staffing Hours per Resident per Day
0.97836
Expected Total Nurse Staffing Hours per Resident per Day
4.29232
Adjusted CNA Staffing Hours per Resident per Day
3.01280
Adjusted LPN Staffing Hours per Resident per Day
1.74404
Adjusted RN Staffing Hours per Resident per Day
0.53531
Adjusted Total Nurse Staffing Hours per Resident per Day
5.00111
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
68
Cycle 1 Standard Survey Health Date
2014-04-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
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
32
Cycle 2 Standard Health Survey Date
2013-01-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2012-05-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
56.00000
Number of Facility Reported Incidents
0
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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