Pine Grove Healthcare & Wellness Centre, Lp - San Gabriel Nursing Home
General Information
UPDATEFederal Provider Number
55056
Provider Name
PINE GROVE HEALTHCARE & WELLNESS CENTRE, LP
Provider Address
126 N. SAN GABRIEL BLVD.
SAN GABRIEL, CA 91775
SAN GABRIEL, CA 91775
Provider Phone Number
6262853131
Provider SSA County
200
Provider County Name
Los Angeles
Ownership Type
For profit - Corporation
Number of Certified Beds
75
Number of Residents in Certified Beds
70
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PINE GROVE HEALTHCARE & WELLNESS CENTRE LP
Date First Approved to Provide Medicare and Medicaid services
1972-01-01
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.66214
Reported LPN Staffing Hours per Resident per Day
0.95929
Reported RN Staffing Hours per Resident per Day
0.58143
Reported Licensed Staffing Hours per Resident per Day
1.54071
Reported Total Nurse Staffing Hours per Resident per Day
4.20286
Reported Physical Therapist Staffing Hours per Resident Per Day
0.29714
Expected CNA Staffing Hours per Resident per Day
2.52105
Expected LPN Staffing Hours per Resident per Day
0.64673
Expected RN Staffing Hours per Resident per Day
1.19373
Expected Total Nurse Staffing Hours per Resident per Day
4.36151
Adjusted CNA Staffing Hours per Resident per Day
2.59102
Adjusted LPN Staffing Hours per Resident per Day
1.23113
Adjusted RN Staffing Hours per Resident per Day
0.36394
Adjusted Total Nurse Staffing Hours per Resident per Day
3.88427
Cycle 1 Total Number of Health Deficiencies
18
Cycle 1 Number of Standard Health Deficiencies
18
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
72
Cycle 1 Standard Survey Health Date
2014-05-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
72
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2013-01-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-01-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
58.00000
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
Nursiong Homes Nearby
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Mission Lodge Sanitarium
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SAN GABRIEL CA 91776 | 0.8 mile away
San Gabriel Valley Medical Ctr D/p Snf
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Mission Care Center
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Live Oak Rehab Center
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Ivy Creek Healthcare & Wellness Centre
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SAN GABRIEL CA 91775 | 1.3 miles away
Vista Cove Care Center At San Gabriel
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San Marino Manor
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Alhambra Healthcare & Wellness Centre, Lp
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El Monte Convalescent Hospital
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Marguerite Gardens
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Monte Vista Grove Homes
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Santa Anita Convalescent Hosp
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Atherton Baptist Home
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Monterey Healthcare & Wellness Centre, Lp
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ROSEMEAD CA 91770 | 2.7 miles away
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