Fireside Convalescent Hospital
947 Third Street, Santa Monica, CA 90403


Fireside Convalescent Hospital is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 555039. The address is 947 Third Street, Santa Monica, CA 90403. The zip code is 90403. The phone number is 3103937117.


Fireside Convalescent Hospital · 947 Third Street, Santa Monica, CA 90403

Federal Provider Number 555039
Provider Name FIRESIDE CONVALESCENT HOSPITAL
Address 947 THIRD STREET
SANTA MONICA, CA 90403
Phone Number 3103937117
SSA County Code 200
County Name Los Angeles
Ownership Type For profit - Corporation
Certified Beds 66
Certified Beds Residents 57
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name F.C.H. INC.
Date First Approved to Provide Medicare Medicaid Services 01/01/1977
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 5
Health Inspection Rating 3
Quality Measure Rating 5
Staffing Rating 4
RN Staffing Rating 4
Reported CNA Staffing Hours per Resident per Day 3.42456
Reported LPN Staffing Hours per Resident per Day 1.62719
Reported RN Staffing Hours per Resident per Day 1.23772
Reported Licensed Staffing Hours per Resident per Day 2.86491
Reported Total Nurse Staffing Hours per Resident per Day 6.28947
Reported Physical Therapist Staffing Hours per Resident Per Day 0.50789
Expected CNA Staffing Hours per Resident per Day 2.46962
Expected LPN Staffing Hours per Resident per Day 0.71507
Expected RN Staffing Hours per Resident per Day 1.48079
Expected Total Nurse Staffing Hours per Resident per Day 4.66548
Adjusted CNA Staffing Hours per Resident per Day 3.40248
Adjusted LPN Staffing Hours per Resident per Day 1.88871
Adjusted RN Staffing Hours per Resident per Day 0.62455
Adjusted Total Nurse Staffing Hours per Resident per Day 5.434
Cycle 1 Total Number of Health Deficiencies 6
Cycle 1 Number of Standard Health Deficiencies 6
Cycle 1 Health Deficiency Score 40
Cycle 1 Standard Survey Health Date 01/10/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 40
Cycle 2 Total Number of Health Deficiencies 15
Cycle 2 Number of Standard Health Deficiencies 14
Cycle 2 Number of Complaint Health Deficiencies 1
Cycle 2 Health Deficiency Score 60
Cycle 2 Standard Health Survey Date 12/07/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 60
Cycle 3 Total Number of Health Deficiencies 15
Cycle 3 Number of Standard Health Deficiencies 14
Cycle 3 Number of Complaint Health Deficiencies 1
Cycle 3 Health Deficiency Score 100
Cycle 3 Standard Health Survey Date 08/15/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 100
Total Weighted Health Survey Score 56.667
Number of Substantiated Complaints 4
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Fireside Convalescent Hospital

Owner Name Role Association Date
DAVEY JAY LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/11/2012
HALL, MARK (Individual) MANAGING EMPLOYEE since 09/01/2011
LAWS, DONALD (Individual) DIRECTOR since 11/01/1994
OAKLEAF HOLDING LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 07/12/2012
OLSEN, SPENCER (Individual) OFFICER since 09/01/2011
SORENSEN, JOHN (Individual) DIRECTOR since 11/01/1994
VERMILLION INVESTMENT CO LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
45%
since 04/01/2010

Santa Monica · Nursing Home

Santa Monica Conv Ctr I 2828 Pico Boulevard, Santa Monica, CA 90405
Beachwood Post-acute & Rehab 1340 15th Street, Santa Monica, CA 90404
Pacific Post Acute 1323 17th Street, Santa Monica, CA 90404
Seaport 17th Care Center 1330 17th Street, Santa Monica, CA 90404
Santa Monica Conv Ctr II 2250 29th Street, Santa Monica, CA 90405
Santa Monica Health Care Center 1320 20th Street, Santa Monica, CA 90404
Brentwood Health Care Center 1321 Franklin Street, Santa Monica, CA 90404
Good Shepherd Hlth Care Ctr of Santa Monica 1131 Arizona Ave., Santa Monica, CA 90401
Berkley West Conv Hosp 1623 Arizona Avenue, Santa Monica, CA 90404
Berkley East Convalescent Hosp 2021 Arizona Ave, Santa Monica, CA 90404
The Rehabilitation Center of Santa Monica 1338 20th Street, Santa Monica, CA 90404

CA · Nursing Home

Rio Hondo Subacute & Nursing Center 273 E Beverly Boulevard, Montebello, CA 90640
Los Banos Nursing & Rehabilitation Center 931 Idaho Ave., Los Banos, CA 93635
Riverside Convalescent Hospital 375 Cohasset Rd, Chico, CA 95926
Somerset Subacute and Care 151 Claydelle Ave, El Cajon, CA 92020
Orchard Hospital D/p Snf 240 Spruce Street, Gridley, CA 95948
Royal Care Skilled Nursing Ctr 2725 Pacific Avenue, Long Beach, CA 90806
Lompoc Valley Medical Ctr Comp Care Ctr D/p Snf 216 N Third Street, Lompoc, CA 93436
Idle Acre Sanitarium & Convalescent Hospital 5044 Buffington Rd., El Monte, CA 91732
Sunnyview Care Center 2000 W Washington Bl, Los Angeles, CA 90018
Del Amo Gardens Convalescent 22419 Kent Avenue, Torrance, CA 90505
Bethel Lutheran Home 2280 Dockery Avenue, Selma, CA 93662
Herman Health Care Center 2295 Plummer Avenue, San Jose, CA 95125
Ararat Convalescent Hospital 2373 Colorado Blvd., Los Angeles, CA 90041
Eskaton Care Center Fair Oaks 11300 Fair Oaks Blvd., Fair Oaks, CA 95628
Brentwood Health Care Center 1321 Franklin Street, Santa Monica, CA 90404
Santa Fe Convalescent Hospital 3294 Santa Fe Avenue, Long Beach, CA 90810
Topanga Terrace 22125 Roscoe Blvd, Canoga Park, CA 91304
Ukiah Post Acute 1349 South Dora St., Ukiah, CA 95482
Downey Care Center 13007 S. Paramount Blvd., Downey, CA 90242
Country Villa Rehabilitation Center 340 South Alvarado Street, Los Angeles, CA 90057
University Care Center 5602 University Ave, San Diego, CA 92105
Kingsley Manor Care Center 1055 N Kingsley Dr, Los Angeles, CA 90029
La Habra Convalescent Hospital 1233 West La Habra Boulevard, La Habra, CA 90631
Windsor Terrace of Westlake Village 250 Fairview Rd, Thousand Oaks, CA 91361
Afvw Health Center 17040 Arnold Dr., Riverside, CA 92518
Alderson Convalescent Hospital 124 Walnut Street, Woodland, CA 95695
Golden Livingcenter - Bakersfield 3601 San Dimas, Bakersfield, CA 93301
Highland Care Center of Redlands 700 East Highland Avenue, Redlands, CA 92374
Lake Forest Nursing Center 25652 Old Trabuco Road, Lake Forest, CA 92630
Woodlands Healthcare Center 14966 Terreno De Flores Lane, Los Gatos, CA 95030
Fruitvale Healthcare Center 3020 East 15th Street, Oakland, CA 94601
Arlington Gardens Care Center 3688 Nye Avenue, Riverside, CA 92505
Danville Rehabilitation 336 Diablo Road, Danville, CA 94526
St Christopher Convalescent Hospital 22822 Myrtle Street, Hayward, CA 94541
Garden View Post- Acute Rehabilitation 14475 Garden View Lane, Baldwin Park, CA 91706
Sunray Healthcare Center 3210 W Pico Blvd, Los Angeles, CA 90019
Laurel Creek Health Center 2800 Estates Drive, Fairfield, CA 94533
Lassen Nursing & Rehabilitation Center 2005 River Street, Susanville, CA 96130
Riverbank Nursing Center 2649 West Topeka Avenue, Riverbank, CA 95367
Sunnyside Conv. Hospital 2939 S. Peach Avenue, Fresno, CA 93725