Royal Care Skilled Nursing Ctr
2725 Pacific Avenue, Long Beach, CA 90806


Royal Care Skilled Nursing Ctr is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 055041. The address is 2725 Pacific Avenue, Long Beach, CA 90806. The zip code is 90806. The phone number is 5624277493.


Royal Care Skilled Nursing Ctr · 2725 Pacific Avenue, Long Beach, CA 90806

Federal Provider Number 055041
Provider Name ROYAL CARE SKILLED NURSING CTR
Address 2725 PACIFIC AVENUE
LONG BEACH, CA 90806
Phone Number 5624277493
SSA County Code 200
County Name Los Angeles
Ownership Type For profit - Corporation
Certified Beds 98
Certified Beds Residents 72
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name COVENANT CARE CALIFORNIA, LLC
Date First Approved to Provide Medicare Medicaid Services 03/01/1978
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 4
Health Inspection Rating 3
Quality Measure Rating 5
Staffing Rating 2
RN Staffing Rating 2
Reported CNA Staffing Hours per Resident per Day 2.34097
Reported LPN Staffing Hours per Resident per Day 0.98333
Reported RN Staffing Hours per Resident per Day 0.5375
Reported Licensed Staffing Hours per Resident per Day 1.52083
Reported Total Nurse Staffing Hours per Resident per Day 3.8618
Reported Physical Therapist Staffing Hours per Resident Per Day 0.15903
Expected CNA Staffing Hours per Resident per Day 2.75999
Expected LPN Staffing Hours per Resident per Day 0.74839
Expected RN Staffing Hours per Resident per Day 1.13303
Expected Total Nurse Staffing Hours per Resident per Day 4.64142
Adjusted CNA Staffing Hours per Resident per Day 2.08118
Adjusted LPN Staffing Hours per Resident per Day 1.09055
Adjusted RN Staffing Hours per Resident per Day 0.35446
Adjusted Total Nurse Staffing Hours per Resident per Day 3.35383
Cycle 1 Total Number of Health Deficiencies 10
Cycle 1 Number of Standard Health Deficiencies 8
Cycle 1 Number of Complaint Health Deficiencies 2
Cycle 1 Health Deficiency Score 68
Cycle 1 Standard Survey Health Date 12/09/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 68
Cycle 2 Total Number of Health Deficiencies 11
Cycle 2 Number of Standard Health Deficiencies 8
Cycle 2 Number of Complaint Health Deficiencies 3
Cycle 2 Health Deficiency Score 52
Cycle 2 Standard Health Survey Date 09/16/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 52
Cycle 3 Total Number of Health Deficiencies 7
Cycle 3 Number of Standard Health Deficiencies 5
Cycle 3 Number of Complaint Health Deficiencies 2
Cycle 3 Health Deficiency Score 48
Cycle 3 Standard Health Survey Date 05/17/2013
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 48
Total Weighted Health Survey Score 59.333
Number of Facility Reported Incidents 4
Number of Substantiated Complaints 2
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Royal Care Skilled Nursing Ctr

Owner Name Role Association Date
ASHLEY, DAVA (Individual) OFFICER since 11/01/2013
ASHLEY, DAVA (Individual) OPERATIONAL/MANAGERIAL CONTROL since 11/01/2013
CARNEY, KEVIN (Individual) OFFICER since 11/01/2013
CENTRE CAPITAL INVESTORS V, LP (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/17/2008
CENTRE COVENANT PURCHASER (B), LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/17/2008
CENTRE COVENANT PURCHASER (Q), LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/17/2008
CENTRE COVENANT PURCHASER (S), LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/19/2008
CENTRE V SECONDARY FUND, L.P. (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/17/2008
COVENANT CARE CALIFORNIA, LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/17/2008
COVENANT CARE, LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/17/2008
COVENANT HOLDCO, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/17/2008
COVENANT SUBCO, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/17/2008
DONOVAN, ROBERT (Individual) OFFICER since 11/01/2013
EVANS, MARY (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/17/2008
EVANS, MARY (Individual) OFFICER since 11/01/2013
GENERAL ELECTRIC CAPITAL CORPORATION (Organization) 5% OR GREATER SECURITY INTEREST since 01/04/2011
LEVIN, ROBERT (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/17/2008
LEVIN, ROBERT (Individual) OFFICER since 11/01/2013
SIMS, CHRISTINE (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/17/2008
SIMS, CHRISTINE (Individual) OFFICER since 11/01/2013
SPARKS, CAROL (Individual) MANAGING EMPLOYEE since 04/17/2006
STATE TREASURER OF MICH CUSTODIAN OF PUBLIC SCHOOL EMPL RTMNT SYSTEMS (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/19/2008
STOCKWELL FUND II LP (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/19/2008
TOROK, ANDREW (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/17/2008
TOROK, ANDREW (Individual) OFFICER since 11/01/2013

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