Country Villa Pavilion Nursing Center
Country Villa Pavilion Nursing Center Information
| Facility Name | Country Villa Pavilion Nursing Center |
| Location | 5916 W. Pico Boulevard, Los Angeles, CA 90035 |
| County (SSA Code) | Los Angeles (200) |
| Phone Number | 323-939-3184 |
| Certification(s) | Medicare and Medicaid |
| Number of Beds | 59 |
| Average Number of Residents | 46.1 |
| CCRC Facility? | No |
| Medicare Overall Rating | |
| Survey Rating | |
| Quality Rating | |
| Long Stay Quality Rating | |
| Short Stay Quality Rating | |
| Staff Quality Rating | |
| Registered Nurse Quality Rating |
| Abuse Flag | No |
| Sprinklers Installed | Yes |
| Located In Hospital | No |
| Resident Family Council | Resident |
| Provider Business Name | Legal Business Name Not Available |
| Ownership Type | For profit - Partnership |
| Date First Approved | 1967-09-01 |
| Reported Nurse Aide Staffing Hours per Resident per Day | 2.48859 |
| Reported LPN Staffing Hours per Resident per Day | 1.15498 |
| Reported RN Staffing - Hours per Resident per Day | 0.589 |
| Reported Licensed Staffing - Hours per Resident per Day (RN + LPN) | 1.74398 |
| Reported Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 4.23257 |
| Reported Physical Therapy Staffing - Hours per Resident Per Day | 0.22818 |
| Case-Mix Nurse Aide Staffing - Hours per Resident per Day | 2.04729 |
| Case-Mix LPN Staffing - Hours per Resident per Day | 0.92791 |
| Case-Mix RN Staffing - Hours per Resident per Day | 0.60201 |
| Case-Mix Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.57721 |
| Adjusted Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.77227 |
| Total Weighted Health Survey Score for three cycles | 50 |
| Rating cycle 1 Standard Survey Health Date | 2019-04-15 |
| Rating cycle 1 - Health Deficiency Score | 14 |
| Rating cycle 1 - Total Health Inspection Score | 48 |
| Date of Rating cycle 2 Standard Health Survey Date | 2018-04-14 |
| Rating cycle 2 - Health Deficiency Score | 48 |
| Date of Rating cycle 3 Standard Health Survey Date | 2017-04-07 |
| Rating cycle 3 - Health Deficiency Score | 36 |
| Rating cycle 3 - Total Health Inspection Score | 36 |
| Number of Facility-Reported Incidents | 3 |
| Number of Substantiated Complaints | 7 |
| Number of Substantiated Complaints | 7 |
| Total Number of Penalties | 0 |
| Data Filing Date | 2020-10-01 |
| Page Last Updated | 2020-11-28 |