Western Conv.hospital - Los Angeles Nursing Home
General Information
UPDATEFederal Provider Number
555069
Provider Name
WESTERN CONV.HOSPITAL
Provider Address
2190 W. ADAMS BLVD.
LOS ANGELES, CA 90018
LOS ANGELES, CA 90018
Provider Phone Number
(323) 737-7778
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
129
Number of Residents in Certified Beds
119
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TZIPPY CARE, INC.
Date First Approved to Provide Medicare and Medicaid services
1977-05-02
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
2.29034
Reported LPN Staffing Hours per Resident per Day
1.67605
Reported RN Staffing Hours per Resident per Day
0.79706
Reported Licensed Staffing Hours per Resident per Day
2.47311
Reported Total Nurse Staffing Hours per Resident per Day
4.76345
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09538
Expected CNA Staffing Hours per Resident per Day
2.52612
Expected LPN Staffing Hours per Resident per Day
0.88219
Expected RN Staffing Hours per Resident per Day
1.38741
Expected Total Nurse Staffing Hours per Resident per Day
4.79573
Adjusted CNA Staffing Hours per Resident per Day
2.22468
Adjusted LPN Staffing Hours per Resident per Day
1.57689
Adjusted RN Staffing Hours per Resident per Day
0.42926
Adjusted Total Nurse Staffing Hours per Resident per Day
4.00377
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
104
Cycle 1 Standard Survey Health Date
2015-04-04
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
19
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
9
Cycle 2 Health Deficiency Score
156
Cycle 2 Standard Health Survey Date
2013-12-08
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
156
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
15
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
88
Cycle 3 Standard Health Survey Date
2012-08-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
88
Total Weighted Health Survey Score
118.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
Number of Fines
1
Total Amount of Fines in Dollars
17550
Number of Payment Denials
2
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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