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
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
Beachwood Post-acute & Rehab 1340 15th Street, Santa Monica, CA 90404
Brentwood Health Care Center 1321 Franklin Street, Santa Monica, CA 90404
Berkley West Conv Hosp 1623 Arizona Avenue, Santa Monica, CA 90404
Good Shepherd Hlth Care Ctr of Santa Monica 1131 Arizona Ave., Santa Monica, CA 90401
The Rehabilitation Center of Santa Monica 1338 20th Street, Santa Monica, CA 90404
Berkley East Convalescent Hosp 2021 Arizona Ave, Santa Monica, CA 90404

CA · Nursing Home

Peninsula Post-acute 1609 Trousdale Drive, Burlingame, CA 94010
Hyde Park Convalescent Hospital 6520 West Blvd., Los Angeles, CA 90043
Eskaton Care Center Fair Oaks 11300 Fair Oaks Blvd., Fair Oaks, CA 95628
Providence West Valley 7057 Shoup Ave, West Hills, CA 91307
Beachside Nursing Center 7781 Garfield Avenue, Huntington Beach, CA 92648
Alhambra Convalescent Hospital 331 Ilene Street, Martinez, CA 94553
Life Care Center of Vista 304 N. Melrose Dr, Vista, CA 92083
Lompoc Skilled Nursing & Rehabilitation Center 1428 W North Ave, Lompoc, CA 93436
College Vista Convalescent Hospital 4681 Eagle Rock Blvd., Los Angeles, CA 90041
Royal Crest Health Care 519 W. Badillo St., Covina, CA 91722
Mocho Park Care Center 752 Holmes Street, Livermore, CA 94550
Oakview Skilled Nursing 3557 Campus Dr, Thousand Oaks, CA 91360
Community Care On Palm 4768 Palm Avenue, Riverside, CA 92501
Asbury Park Nursing & Rehabilitation Center 2257 Fair Oaks Blvd., Sacramento, CA 95825
California Convalescent Center 1 909 S Lake Street, Los Angeles, CA 90006
Mayflower Care Center 5043 Peck Rd, El Monte, CA 91732
Sierra View Medical Center 465 W Putnam Ave, Porterville, CA 93257
Excell Health Care Center 3025 High Street, Oakland, CA 94619
Casa De Las Campanas 18655 W. Bernardo Drive, San Diego, CA 92127
The Redwoods, A Community of Seniors 40 Camino Alto, Mill Valley, CA 94941
Devonshire Care Center 1350 East Devonshire Avenue, Hemet, CA 92544
Orchard Hospital D/p Snf 240 Spruce Street, Gridley, CA 95948
Crystal Cove Care Center 1445 Superior Avenue, Newport Beach, CA 92663
Coalinga Regional Medical Ctr Dp/snf 1191 Phelps Ave., Coalinga, CA 93210
Emerald Terrace Conv Hospital 1154 S.alvarado St, Los Angeles, CA 90006
Golden Livingcenter - Petaluma 101 Monroe Street, Petaluma, CA 94954
Arbor Glen Care Center 1033 E. Arrow Highway, Glendora, CA 91740
Riverside Convalescent Hospital 375 Cohasset Rd, Chico, CA 95926
Broadway Healthcare Center 112 E. Broadway, San Gabriel, CA 91776
Simi Valley Care Center 5270 E Los Angeles Ave, Simi Valley, CA 93063
Folsom Care Center 510 Mill Street, Folsom, CA 95630
Windsor Gardens Care Center of Hayward 1628 B Street, Hayward, CA 94541
Kit Carson Nursing & Rehabilitation Center 811 Court Street, Jackson, CA 95642
Windsor Gardens Rehabilitation Center of Salinas 637 East Romie Lane, Salinas, CA 93901
Kindred Nursing and Rehabilitation - Medical Hill 475 29th Street, Oakland, CA 94609
Hy-lond Health Care Center-merced 3170 M Street, Merced, CA 95340
Herman Health Care Center 2295 Plummer Avenue, San Jose, CA 95125
Windsor Park Care Center of Fremont 2400 Parkside Drive, Fremont, CA 94536
Sherwood Healthcare Center 4700 Elvas Ave, Sacramento, CA 95819
Rio Hondo Subacute & Nursing Center 273 E Beverly Boulevard, Montebello, CA 90640