Southern California Hosp At Culver City D/p Snf - Culver City Nursing Home
General Information
UPDATEFederal Provider Number
555874
Provider Name
SOUTHERN CALIFORNIA HOSP AT CULVER CITY D/P SNF
Provider Address
3828 DELMAS TERRACE
CULVER CITY, CA 90230
CULVER CITY, CA 90230
Provider Phone Number
(323) 836-7000
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
21
Number of Residents in Certified Beds
11
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SOUTHERN CALIFORNIA HEALTHCARE SYSTEM, INC
Date First Approved to Provide Medicare and Medicaid services
2012-06-29
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
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
0.93636
Reported LPN Staffing Hours per Resident per Day
2.22273
Reported RN Staffing Hours per Resident per Day
2.84545
Reported Licensed Staffing Hours per Resident per Day
5.06818
Reported Total Nurse Staffing Hours per Resident per Day
6.00454
Reported Physical Therapist Staffing Hours per Resident Per Day
0.25909
Expected CNA Staffing Hours per Resident per Day
2.26121
Expected LPN Staffing Hours per Resident per Day
0.72547
Expected RN Staffing Hours per Resident per Day
1.81409
Expected Total Nurse Staffing Hours per Resident per Day
4.80077
Adjusted CNA Staffing Hours per Resident per Day
1.01607
Adjusted LPN Staffing Hours per Resident per Day
2.54300
Adjusted RN Staffing Hours per Resident per Day
1.17200
Adjusted Total Nurse Staffing Hours per Resident per Day
5.04163
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-03-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2012-12-04
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
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2011-11-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
36.66700
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
1
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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