| General |
| City |
| San Gabriel |
Santa Monica |
| State attribute explanation |
| Ca |
Ca |
| Street |
| 126 N. San Gabriel Blvd. |
1330 17th Street |
| Zip Code |
| 91,775 |
90,404 |
| Phone |
| 6,262,853,131 |
3,108,295,411 |
|
Overall Star Rating |
| 4 |
4 |
|
Health Inspections Star Rating |
| 4 |
4 |
|
Nurse Staffing Star Rating |
| 4 |
4 |
|
Quality Measures Star Rating |
| 2 |
3 |
|
RN Only Star Rating |
| 4 |
3 |
| Number of Certified Beds |
| 75 |
72 |
|
Total Number of Residents |
| 61 |
60 |
|
Percent of Occupied Beds |
| 81 % |
83 % |
| Health Survey Date |
| 1/11/2012 |
9/13/2011 |
| Fire Survey Date |
| 1/11/2012 |
9/13/2011 |
| Sprinkler Status |
| Fully Sprinklered |
Fully Sprinklered |
| Program Participation |
| Medicare And Medicaid |
Medicare And Medicaid |
| Type of Ownership |
| For Profit - Corporation |
For Profit - Partnership |
| Located Within a Hospital? |
| No |
No |
| Multi Nursing Home Ownership? |
| No |
No |
| Resident and Family Councils |
| Resident |
None |
| 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 |
| 61 |
60 |
| Number of RN Hours Per Resident Per Day |
| 0.73 |
0.64 |
| Number of LPN/LVN Hours Per Resident Per Day |
| 0.77 |
1.02 |
| Total Number of Licensed Staff Hours Per Resident Per Day |
| 1.50 |
1.66 |
| Number of CNA Hours Per Resident Per Day |
| 0.09 |
0.3 |
| Number Therapy Hours Per Resident Per Day |
| 0.09 |
0.3 |
| Administration Deficiencies |
| Deficiency #1 |
|
Scope: Manylevel Of Harm: 1deficiency: Operate And Provide Services According To Federal, State, And Local Laws And Professional Standards.survey Date: 06/27/2012date Of Correction: 07/17/2012 |
| Quality Measures Q1 |
| Percent of long-stay residents who received an antipsychotic medication |
| 17.9 (64.2) |
32.4 (90.3) |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 75.2 % |
75.2 % |
| Percent of long-stay residents who self-report moderate to severe pain |
| 2.8 % |
|
| Percent of long-stay high-risk residents with pressure ulcers |
| 20 % |
3.2 % |
| Percent of long-stay residents who lose too much weight |
| 10.9 % |
8.3 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 9.5 % |
4.5 % |
| Percent of long-stay residents with a urinary tract infection |
| 23.6 % |
16.7 % |
| Percent of long-stay residents who have depressive symptoms |
| 7.1 % |
75.2 % |
| Percent of long-stay residents who were physically restrained |
| 1.8 % |
15.8 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 20.4 % |
23.6 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 36.1 % |
94.9 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 39.3 % |
91.5 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 4 % |
2.6 / 3 |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 1.8 % |
75.2 % |
| Quality Measures Q3 |
| Percent of long-stay residents who received an antipsychotic medication |
| 14.2 % |
38.1 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 4.3 % |
0.9 % |
| Percent of long-stay residents who self-report moderate to severe pain |
| 4.3 % |
9.2 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 17.4 % |
7.3 % |
| Percent of long-stay residents who lose too much weight |
| 8.9 / 9.9 |
2.6 / 3 |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 71.4 % |
43.2 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 7.4 % |
3 % |
| Percent of long-stay residents with a urinary tract infection |
| 12.5 % |
15.8 % |
| Percent of long-stay residents who have depressive symptoms |
| 11.8:1 |
2.6 / 3 |
| Percent of long-stay residents who were physically restrained |
| 1.8 % |
19.7 % |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 1.8 % |
75.2 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 24.5 % |
22.6 % |
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 39.3 % |
96 % |
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 37.1 % |
91.8 % |
| Percent of short-stay residents who newly received an antipsychotic medication |
| 2.8 % |
17.5 % |