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Detailed information-PROVIDENCE ST ELIZABETH CARE CENTER
This is the detailed information about PROVIDENCE ST ELIZABETH CARE CENTER, including its zip code, address, phone, federal provider number, state, overall rating, etc.
Federal Provider Number: 055192
Provider Name: PROVIDENCE ST ELIZABETH CARE CENTER
Provider State: CA
Provider Zip Code: 91601
Ownership Type: Non profit - Church related
Number of Substantiated Complaints: 1
Provider Phone Number: 8189803872
Provider City: NORTH HOLLYWOOD
Provider SSA County Code: 200
Provider County Name: Los Angeles
Provider Address: 10425 MAGNOLIA BLVD
Number of Certified Beds: 52
Number of Residents in Certified Beds: 37.9
Provider Type: Medicare and Medicaid
Provider Resides in Hospital: N
Legal Business Name: PROVIDENCE HEALTH SYSTEM-SOUTHERN CALIFORNIA
Date First Approved to Provide Medicare and Medicaid services: 1973-06-01
Continuing Care Retirement Community: N
Special Focus Facility: N
Most Recent Health Inspection More Than 2 Years Ago: N
Provider Changed Ownership in Last 12 Months: N
With a Resident and Family Council: Resident
Automatic Sprinkler Systems in All Required Areas: Yes
Reported Staffing Footnote:
Physical Therapist Staffing Footnote:
Reported CNA Staffing Hours per Resident per Day: 2.75366
Reported LPN Staffing Hours per Resident per Day: 1.04990
Reported RN Staffing Hours per Resident per Day: 0.15142
Reported Licensed Staffing Hours per Resident per Day: 1.20132
Reported Total Nurse Staffing Hours per Resident per Day: 3.95498
Reported Physical Therapist Staffing Hours per Resident Per Day: 0.03611
Expected CNA Staffing Hours per Resident per Day: 1.94922
Expected LPN Staffing Hours per Resident per Day: 0.68782
Expected RN Staffing Hours per Resident per Day: 0.30915
Expected Total Nurse Staffing Hours per Resident per Day: 2.94620
Adjusted CNA Staffing Hours per Resident per Day: 2.95146
Adjusted LPN Staffing Hours per Resident per Day: 1.15833
Adjusted RN Staffing Hours per Resident per Day: 0.18632
Adjusted Total Nurse Staffing Hours per Resident per Day: 4.33396
Health Survey Date Under New Process: No Health Inspection since 11/28/2017
Number of Health Deficiencies on Survey Under New Process: Not Applicable
Severity of Most Severe Deficiency Cited Under New Process: Not Applicable
Largest Number of Residents Affected by Deficiency Cited Under New Process: Not Applicable
Date of Previous Standard Health Inspection: 05/14/2017
Number of Health Deficiencies on Previous Standard Health Inspection: 6
Total Weighted Health Survey Score: 24.800
Number of Facility Reported Incidents: 0
Number of Fines: 0
Total Amount of Fines in Dollars: 0
Number of Payment Denials: 0
Total Number of Penalties: 0
Processing Date: 2018-04-01