Valley Manor Conv Hosp - North Hollywood Nursing Home

General Information

UPDATE
Federal Provider Number
555132
Provider Name
VALLEY MANOR CONV HOSP
Provider Address
6120 N. VINELAND AVE
NORTH HOLLYWOOD, CA 91606
Provider Phone Number
(818) 763-6275
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
72
Number of Residents in Certified Beds
64
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GOLDEN CARE, INC.
Date First Approved to Provide Medicare and Medicaid services
1981-03-13
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
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.93281
Reported LPN Staffing Hours per Resident per Day
0.81484
Reported RN Staffing Hours per Resident per Day
0.32422
Reported Licensed Staffing Hours per Resident per Day
1.13906
Reported Total Nurse Staffing Hours per Resident per Day
4.07187
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00469
Expected CNA Staffing Hours per Resident per Day
2.15032
Expected LPN Staffing Hours per Resident per Day
0.57183
Expected RN Staffing Hours per Resident per Day
0.83690
Expected Total Nurse Staffing Hours per Resident per Day
3.55905
Adjusted CNA Staffing Hours per Resident per Day
3.34659
Adjusted LPN Staffing Hours per Resident per Day
1.18272
Adjusted RN Staffing Hours per Resident per Day
0.28947
Adjusted Total Nurse Staffing Hours per Resident per Day
4.61171
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
48
Cycle 1 Standard Survey Health Date
2015-02-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-10-31
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
11
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-07-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
49.33300
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
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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