| General |
| City |
| Los Angeles |
Pacifica |
| State attribute explanation |
| Ca |
Ca |
| Street |
| 2625 S. Maple Ave. |
751 San Pedro Terrace Road |
| Zip Code |
| 90,011 |
94,044 |
| Phone |
| 2,137,476,371 |
6,503,594,800 |
|
Overall Star Rating |
| 5 |
5 |
|
Health Inspections Star Rating |
| 3 |
5 |
|
Nurse Staffing Star Rating |
| 4 |
5 |
|
Quality Measures Star Rating |
| 5 |
5 |
|
RN Only Star Rating |
| 3 |
5 |
|
Number of Certified Beds |
| 59 |
59 |
|
Total Number of Residents |
| 55 |
56 |
|
Percent of Occupied Beds |
| 93 % |
95 % |
| Health Survey Date |
| 9/2/2011 |
12/5/2011 |
| Fire Survey Date |
| 8/31/2011 |
12/16/2011 |
| Sprinkler Status |
| Fully Sprinklered |
Fully Sprinklered |
| Program Participation |
| Medicare And Medicaid |
Medicare And Medicaid |
| Type of Ownership |
| For Profit - Corporation |
For Profit - Corporation |
| Located Within a Hospital? |
| No |
No |
| Multi Nursing Home Ownership? |
| Yes |
No |
| Resident and Family Councils |
| Both |
Both |
| Continuing Care Retirement Community? |
| No |
No |
| Quality Indicator Survey? |
| No |
No |
| Special Focus Facility? |
| No |
No |
| Civil Money Penalty Count |
| 75.2 |
75.2 |
| Total Enforcement Actions Count |
| 75.2 |
75.2 |
| # of deficiencies |
| 1 |
|
|
| Staff Information |
| Number of Residents |
| 55 |
56 |
| Number of RN Hours Per Resident Per Day |
| 0.67 |
1.91 |
| Number of LPN/LVN Hours Per Resident Per Day |
| 0.51 |
1 |
| Total Number of Licensed Staff Hours Per Resident Per Day |
| 1.18 |
2.91 |
| Number of CNA Hours Per Resident Per Day |
| 75.2 |
0.3 |
| Number Therapy Hours Per Resident Per Day |
|
0.3 |
| Quality Care Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 3deficiency: Provide Necessary Care And Services To Maintain The Highest Well Being Of Each Resident .survey Date: 04/11/2011date Of Correction: 10/27/2011 |
|
| Quality Measures Q1 |
| Percent of long-stay residents who received an antipsychotic medication |
| 21.4 % |
10 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
|
0.8 % |
| Percent of long-stay residents who self-report moderate to severe pain |
| 75.2 % |
75.2 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 12.1:1 |
5.7 % |
| Percent of long-stay residents who lose too much weight |
| 8.9 / 9.9 |
2.5 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 1.6 % |
10.9 % |
| Percent of long-stay residents with a urinary tract infection |
| 75.2 % |
75.2 % |
| Percent of long-stay residents who have depressive symptoms |
| 75.2 % |
75.2 % |
| Percent of long-stay residents who were physically restrained |
| 1.8 % |
75.2 % |
| Percent of short-stay residents who self-report moderate to severe pain |
|
75.2 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
|
100 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
|
100 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
|
1.7 % |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 75.2 % |
2.5 % |
| Quality Measures Q3 |
| Percent of long-stay residents who received an antipsychotic medication |
| 24.4 % |
9.2 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 6.3 % |
0.9 % |
| Percent of long-stay residents who self-report moderate to severe pain |
| 1.3 % |
75.2 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 10.1:1 |
6 % |
| Percent of long-stay residents who lose too much weight |
| 9.6 % |
2.6 / 3 |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
|
50 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 0.5 - 2.0 |
8.8 % |
| Percent of long-stay residents with a urinary tract infection |
| 75.2 % |
1.7 % |
| Percent of long-stay residents who have depressive symptoms |
| 75.2 % |
75.2 % |
| Percent of long-stay residents who were physically restrained |
| 1.2 % |
75.2 % |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 75.2 % |
0.8 % |
| Percent of short-stay residents who self-report moderate to severe pain |
|
0.7 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 87 % |
98.4 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 100 % |
98.7 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
|
0.6 % |