Beachwood Post-acute & Rehab
1340 15th Street, Santa Monica, CA 90404


Beachwood Post-acute & Rehab is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 056334. The address is 1340 15th Street, Santa Monica, CA 90404. The zip code is 90404. The phone number is 3104519706.


Beachwood Post-acute & Rehab · 1340 15th Street, Santa Monica, CA 90404

Federal Provider Number 056334
Provider Name BEACHWOOD POST-ACUTE & REHAB
Address 1340 15TH STREET
SANTA MONICA, CA 90404
Phone Number 3104519706
SSA County Code 200
County Name Los Angeles
Ownership Type For profit - Corporation
Certified Beds 227
Certified Beds Residents 172
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name CANTALOUPE HOLDINGS LLC
Date First Approved to Provide Medicare Medicaid Services 07/14/1972
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 2
Health Inspection Rating 1
Quality Measure Rating 4
Staffing Rating 4
RN Staffing Rating 4
Reported CNA Staffing Hours per Resident per Day 2.51366
Reported LPN Staffing Hours per Resident per Day 1.91541
Reported RN Staffing Hours per Resident per Day 0.89564
Reported Licensed Staffing Hours per Resident per Day 2.81105
Reported Total Nurse Staffing Hours per Resident per Day 5.32471
Reported Physical Therapist Staffing Hours per Resident Per Day 0.02907
Expected CNA Staffing Hours per Resident per Day 2.62994
Expected LPN Staffing Hours per Resident per Day 0.84196
Expected RN Staffing Hours per Resident per Day 1.22206
Expected Total Nurse Staffing Hours per Resident per Day 4.69396
Adjusted CNA Staffing Hours per Resident per Day 2.34521
Adjusted LPN Staffing Hours per Resident per Day 1.8882
Adjusted RN Staffing Hours per Resident per Day 0.54762
Adjusted Total Nurse Staffing Hours per Resident per Day 4.57255
Cycle 1 Total Number of Health Deficiencies 17
Cycle 1 Number of Standard Health Deficiencies 17
Cycle 1 Health Deficiency Score 120
Cycle 1 Standard Survey Health Date 08/24/2016
Cycle 1 Number of Health Revisits 2
Cycle 1 Health Revisit Score 60
Cycle 1 Total Health Score 180
Cycle 2 Total Number of Health Deficiencies 36
Cycle 2 Number of Standard Health Deficiencies 25
Cycle 2 Number of Complaint Health Deficiencies 11
Cycle 2 Health Deficiency Score 236
Cycle 2 Standard Health Survey Date 05/26/2015
Cycle 2 Number of Health Revisits 3
Cycle 2 Health Revisit Score 165
Cycle 2 Total Health Score 401
Cycle 3 Total Number of Health Deficiencies 22
Cycle 3 Number of Standard Health Deficiencies 20
Cycle 3 Number of Complaint Health Deficiencies 2
Cycle 3 Health Deficiency Score 116
Cycle 3 Standard Health Survey Date 01/29/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 116
Total Weighted Health Survey Score 243
Number of Facility Reported Incidents 3
Number of Substantiated Complaints 16
Number of Fines 1
Total Amount of Fines in Dollars $37892.00
Number of Payment Denials 1
Total Number of Penalties 2
Processing Date 08/01/2017

Owner or Manager · Beachwood Post-acute & Rehab

Owner Name Role Association Date
ANDERSON, NICKLAS (Individual) OFFICER since 01/15/2017
ANDERSON, NICKLAS (Individual) OPERATIONAL/MANAGERIAL CONTROL since 01/15/2017
AUBURN MANOR HOLDING CORP (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 06/30/2015
BAY BRIDGE CAPITAL PARTNERS, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 06/30/2015
CALIFORNIA OPCO LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 06/30/2015
CROSSWINDS TRUST (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 06/30/2015
FLOWER FARM GROUP, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 06/30/2015
GI PLUM HOLDINGS, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 06/30/2015
HEALTHCARE FINANCIAL SOLUTIONS, LLC (Organization) 5% OR GREATER MORTGAGE INTEREST since 11/30/2015
HORIZON WEST HEALTHCARE, INC. (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 06/30/2015
NEW SISU HOLDCO, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 06/30/2015
OPCO HOLDINGS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 06/30/2015
PUGH, PHYLLIS (Individual) OFFICER since 06/30/2015
PUGH, PHYLLIS (Individual) OPERATIONAL/MANAGERIAL CONTROL since 06/30/2015

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