White Memorial Medical Ctr Dp - Los Angeles Nursing Home
General Information
UPDATEFederal Provider Number
555312
Provider Name
WHITE MEMORIAL MEDICAL CTR DP
Provider Address
1720 CESAR E. CHAVEZ AVENUE
LOS ANGELES, CA 90033
LOS ANGELES, CA 90033
Provider Phone Number
(323) 268-5000
Provider SSA County
200
Provider County Name
Los Angeles
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
41
Number of Residents in Certified Beds
12
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
WHITE MEMORIAL MEDICAL CENTER
Date First Approved to Provide Medicare and Medicaid services
1988-08-29
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
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
5
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
3.21250
Reported LPN Staffing Hours per Resident per Day
0.85833
Reported RN Staffing Hours per Resident per Day
6.02500
Reported Licensed Staffing Hours per Resident per Day
6.88333
Reported Total Nurse Staffing Hours per Resident per Day
10.09583
Reported Physical Therapist Staffing Hours per Resident Per Day
0.70417
Expected CNA Staffing Hours per Resident per Day
2.21015
Expected LPN Staffing Hours per Resident per Day
0.89652
Expected RN Staffing Hours per Resident per Day
1.92999
Expected Total Nurse Staffing Hours per Resident per Day
5.03665
Adjusted CNA Staffing Hours per Resident per Day
3.56651
Adjusted LPN Staffing Hours per Resident per Day
0.79465
Adjusted RN Staffing Hours per Resident per Day
2.33260
Adjusted Total Nurse Staffing Hours per Resident per Day
8.07982
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-07-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-04-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
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
2012-01-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
36.00000
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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