Presbyterian Intercomm Hosp Dp/snf - Whittier Nursing Home

General Information

UPDATE
Federal Provider Number
555654
Provider Name
PRESBYTERIAN INTERCOMM HOSP DP/SNF
Provider Address
12401 WASHINGTON BLVD.
WHITTIER, CA 90602
Provider Phone Number
(562) 698-0811
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
35
Number of Residents in Certified Beds
35
Provider Type
Medicare
Provider Resides in Hospital
Y
Legal Business Name
PRESBYTERIAN INTERCOMMUNITY HOSPITAL INC
Date First Approved to Provide Medicare and Medicaid services
1996-02-15
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
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
5
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
2.59714
Reported LPN Staffing Hours per Resident per Day
1.17571
Reported RN Staffing Hours per Resident per Day
2.20429
Reported Licensed Staffing Hours per Resident per Day
3.38000
Reported Total Nurse Staffing Hours per Resident per Day
5.97714
Reported Physical Therapist Staffing Hours per Resident Per Day
0.49000
Expected CNA Staffing Hours per Resident per Day
2.26263
Expected LPN Staffing Hours per Resident per Day
0.91166
Expected RN Staffing Hours per Resident per Day
1.95721
Expected Total Nurse Staffing Hours per Resident per Day
5.13150
Adjusted CNA Staffing Hours per Resident per Day
2.81646
Adjusted LPN Staffing Hours per Resident per Day
1.07040
Adjusted RN Staffing Hours per Resident per Day
0.84153
Adjusted Total Nurse Staffing Hours per Resident per Day
4.69517
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-06-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-03-16
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
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2011-12-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
44.00000
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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