Serrano North Convalescent Hospital - Los Angeles Nursing Home
General Information
UPDATEFederal Provider Number
56489
Provider Name
SERRANO NORTH CONVALESCENT HOSPITAL
Provider Address
5401 FOUNTAIN AVE.
LOS ANGELES, CA 90029
LOS ANGELES, CA 90029
Provider Phone Number
(323) 465-2106
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
98
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
NORTH STAR HEALTHCARE, LLC
Date First Approved to Provide Medicare and Medicaid services
1975-04-07
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
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
3.13520
Reported LPN Staffing Hours per Resident per Day
0.87704
Reported RN Staffing Hours per Resident per Day
0.55867
Reported Licensed Staffing Hours per Resident per Day
1.43571
Reported Total Nurse Staffing Hours per Resident per Day
4.57091
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02755
Expected CNA Staffing Hours per Resident per Day
2.34039
Expected LPN Staffing Hours per Resident per Day
0.66815
Expected RN Staffing Hours per Resident per Day
1.00511
Expected Total Nurse Staffing Hours per Resident per Day
4.01365
Adjusted CNA Staffing Hours per Resident per Day
3.28699
Adjusted LPN Staffing Hours per Resident per Day
1.08950
Adjusted RN Staffing Hours per Resident per Day
0.41531
Adjusted Total Nurse Staffing Hours per Resident per Day
4.59056
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2014-09-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-06-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
52
Cycle 3 Total Number of Health Deficiencies
16
Cycle 3 Number of Standard Health Deficiencies
16
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
84
Cycle 3 Standard Health Survey Date
2012-02-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
84
Total Weighted Health Survey Score
63.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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