Serrano South Convalescent Hospital - Los Angeles Nursing Home
General Information
UPDATEFederal Provider Number
56456
Provider Name
SERRANO SOUTH CONVALESCENT HOSPITAL
Provider Address
5400 FOUNTAIN AVE
LOS ANGELES, CA 90029
LOS ANGELES, CA 90029
Provider Phone Number
(323) 461-4301
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
88
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SOUTH FORK HEALTHCARE, LLC
Date First Approved to Provide Medicare and Medicaid services
1975-02-04
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
4
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
3.10000
Reported LPN Staffing Hours per Resident per Day
0.70682
Reported RN Staffing Hours per Resident per Day
0.44943
Reported Licensed Staffing Hours per Resident per Day
1.15625
Reported Total Nurse Staffing Hours per Resident per Day
4.25625
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03068
Expected CNA Staffing Hours per Resident per Day
2.21539
Expected LPN Staffing Hours per Resident per Day
0.55408
Expected RN Staffing Hours per Resident per Day
0.83815
Expected Total Nurse Staffing Hours per Resident per Day
3.60762
Adjusted CNA Staffing Hours per Resident per Day
3.43346
Adjusted LPN Staffing Hours per Resident per Day
1.05881
Adjusted RN Staffing Hours per Resident per Day
0.40066
Adjusted Total Nurse Staffing Hours per Resident per Day
4.75563
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
104
Cycle 1 Standard Survey Health Date
2014-08-28
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
104
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
76
Cycle 2 Standard Health Survey Date
2013-06-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
76
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2012-02-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
88.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
6
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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