Overall Rating
Address
5901 Downey Ave
Long Beach, CA 90805
Contact
5626344693
Certification Date
1985-10-09
CMS Certification Number
056042
Ownership Type
For profit - Corporation
Number of Certified Beds
70
Average Number of Residents per Day
64.4
Provider Type
Medicare and Medicaid
Legal Business Name
COUNTRY VILLA SOUTH BAY, LLC
Affiliated Entity Name
COUNTRY VILLA HEALTH SERVICES
Affiliated Entity ID
165
Health Inspection Rating
1
Quality Measure Rating
5
Staffing Rating
4
Reported Nurse Aide Staffing Hours per Resident per Day
2.29975
Reported LPN Staffing Hours per Resident per Day
1.14456
Reported RN Staffing Hours per Resident per Day
0.44496
Reported Total Nurse Staffing Hours per Resident per Day
3.88927
Total Number of Nurse Staff Hours per Resident per Day on the Weekend
3.59316
Registered Nurse Hours per Resident per Day on the Weekend
0.43950
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04882
Long-Stay Quality Measure Rating
5
Short-Stay Quality Measure Rating
5
Total Weighted Health Survey Score
238.500
Number of Facility Reported Incidents
4
Number of Substantiated Complaints
10
Number of Citations from Infection Control Inspections
Standard Health Survey Date
2021-07-19
Total Number of Health Deficiencies
24
Number of Standard Health Deficiencies
19
Number of Complaint Health Deficiencies
5
Health Deficiency Score
373
Number of Health Revisits
1
Health Revisit Score
0
Total Health Score
373
Standard Health Survey Date
2019-12-23
Total Number of Health Deficiencies
25
Number of Standard Health Deficiencies
16
Number of Complaint Health Deficiencies
9
Health Deficiency Score
140
Number of Health Revisits
1
Health Revisit Score
0
Total Health Score
140
Standard Health Survey Date
2018-12-21
Total Number of Health Deficiencies
6
Number of Standard Health Deficiencies
4
Number of Complaint Health Deficiencies
2
Health Deficiency Score
32
Number of Health Revisits
1
Health Revisit Score
0
Total Health Score
32
Number of Fines
4
Total Amount of Fines in Dollars
55709.39
Number of Payment Denials
0
Total Number of Penalties
4