Shadow Hills Conv. Hospital - Sunland Nursing Home
General Information
UPDATEFederal Provider Number
555045
Provider Name
SHADOW HILLS CONV. HOSPITAL
Provider Address
10158 SUNLAND BLVD
SUNLAND, CA 91040
SUNLAND, CA 91040
Provider Phone Number
8183537800
Provider SSA County
200
Provider County Name
Los Angeles
Ownership Type
For profit - Corporation
Number of Certified Beds
67
Number of Residents in Certified Beds
66
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ORLANDO CLARIZIO
Date First Approved to Provide Medicare and Medicaid services
1976-11-08
Continuing Care Retirement Community
N
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.25076
Reported LPN Staffing Hours per Resident per Day
0.72500
Reported RN Staffing Hours per Resident per Day
0.30303
Reported Licensed Staffing Hours per Resident per Day
1.02803
Reported Total Nurse Staffing Hours per Resident per Day
3.27879
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02197
Expected CNA Staffing Hours per Resident per Day
2.10149
Expected LPN Staffing Hours per Resident per Day
0.56702
Expected RN Staffing Hours per Resident per Day
0.83282
Expected Total Nurse Staffing Hours per Resident per Day
3.50132
Adjusted CNA Staffing Hours per Resident per Day
2.62799
Adjusted LPN Staffing Hours per Resident per Day
1.06125
Adjusted RN Staffing Hours per Resident per Day
0.27188
Adjusted Total Nurse Staffing Hours per Resident per Day
3.77471
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2015-01-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-10-20
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
12
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-06-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
44.00000
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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