Skyline Healthcare Center - La - Los Angeles Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
555117
Provider Name
SKYLINE HEALTHCARE CENTER - LA
Provider Address
3032 ROWENA AVE
LOS ANGELES, CA 90039
LOS ANGELES, CA 90039
Provider Phone Number
(213) 665-1185
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
99
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SKYLINE HEALTHCARE & WELLNESS CENTER, LLC
Date First Approved to Provide Medicare and Medicaid services
1979-03-15
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
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.38990
Reported LPN Staffing Hours per Resident per Day
0.56869
Reported RN Staffing Hours per Resident per Day
0.97525
Reported Licensed Staffing Hours per Resident per Day
1.54394
Reported Total Nurse Staffing Hours per Resident per Day
3.93384
Reported Physical Therapist Staffing Hours per Resident Per Day
0.16616
Expected CNA Staffing Hours per Resident per Day
2.42214
Expected LPN Staffing Hours per Resident per Day
0.69500
Expected RN Staffing Hours per Resident per Day
1.27533
Expected Total Nurse Staffing Hours per Resident per Day
4.39247
Adjusted CNA Staffing Hours per Resident per Day
2.42104
Adjusted LPN Staffing Hours per Resident per Day
0.67915
Adjusted RN Staffing Hours per Resident per Day
0.57139
Adjusted Total Nurse Staffing Hours per Resident per Day
3.61002
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
16
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2015-02-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2013-10-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
68
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2012-07-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
68.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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