Country Villa North
Country Villa North Information
| Facility Name | Country Villa North |
| Location | 3233 W. Pico Boulevard, Los Angeles, CA 90019 |
| County (SSA Code) | Los Angeles (200) |
| Phone Number | 323-734-9122 |
| Certification(s) | Medicare and Medicaid |
| Number of Beds | 99 |
| Average Number of Residents | 72.3 |
| 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 - Limited Liability company |
| Date First Approved | 1979-06-01 |
| Reported Nurse Aide Staffing Hours per Resident per Day | 2.66675 |
| Reported LPN Staffing Hours per Resident per Day | 1.22148 |
| Reported RN Staffing - Hours per Resident per Day | 0.57498 |
| Reported Licensed Staffing - Hours per Resident per Day (RN + LPN) | 1.79646 |
| Reported Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 4.46322 |
| Reported Physical Therapy Staffing - Hours per Resident Per Day | 0.03856 |
| Case-Mix Nurse Aide Staffing - Hours per Resident per Day | 2.04239 |
| Case-Mix LPN Staffing - Hours per Resident per Day | 0.68687 |
| Case-Mix RN Staffing - Hours per Resident per Day | 0.30013 |
| Case-Mix Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.02939 |
| Adjusted Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 4.69716 |
| Total Weighted Health Survey Score for three cycles | 167.333 |
| Rating cycle 1 Standard Survey Health Date | 2019-04-04 |
| Rating cycle 1 - Health Deficiency Score | 18 |
| Rating cycle 1 - Total Health Inspection Score | 64 |
| Date of Rating cycle 2 Standard Health Survey Date | 2018-03-26 |
| Rating cycle 2 - Health Deficiency Score | 64 |
| Date of Rating cycle 3 Standard Health Survey Date | 2017-03-08 |
| Rating cycle 3 - Health Deficiency Score | 84 |
| Rating cycle 3 - Total Health Inspection Score | 84 |
| Number of Facility-Reported Incidents | 4 |
| Number of Substantiated Complaints | 11 |
| Number of Substantiated Complaints | 11 |
| Total Number of Penalties | 0 |
| Data Filing Date | 2020-10-01 |
| Page Last Updated | 2020-11-28 |