Golden Cross Health Care
1450 N. Fair Oaks Avenue, Pasadena, CA 91103


Golden Cross Health Care is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 555096. The address is 1450 N. Fair Oaks Avenue, Pasadena, CA 91103. The zip code is 91103. The phone number is 6267911948.


Golden Cross Health Care · 1450 N. Fair Oaks Avenue, Pasadena, CA 91103

Federal Provider Number 555096
Provider Name GOLDEN CROSS HEALTH CARE
Address 1450 N. FAIR OAKS AVENUE
PASADENA, CA 91103
Phone Number 6267911948
SSA County Code 200
County Name Los Angeles
Ownership Type For profit - Corporation
Certified Beds 96
Certified Beds Residents 91
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name 1450 NORTH FAIR OAKS LLC
Date First Approved to Provide Medicare Medicaid Services 08/01/1978
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 2
Health Inspection Rating 1
Quality Measure Rating 5
Staffing Rating 2
RN Staffing Rating 1
Reported CNA Staffing Hours per Resident per Day 2.50549
Reported LPN Staffing Hours per Resident per Day 1.00275
Reported RN Staffing Hours per Resident per Day 0.2467
Reported Licensed Staffing Hours per Resident per Day 1.24945
Reported Total Nurse Staffing Hours per Resident per Day 3.75494
Reported Physical Therapist Staffing Hours per Resident Per Day 0.01264
Expected CNA Staffing Hours per Resident per Day 2.23051
Expected LPN Staffing Hours per Resident per Day 0.54475
Expected RN Staffing Hours per Resident per Day 0.85164
Expected Total Nurse Staffing Hours per Resident per Day 3.6269
Adjusted CNA Staffing Hours per Resident per Day 2.7562
Adjusted LPN Staffing Hours per Resident per Day 1.52784
Adjusted RN Staffing Hours per Resident per Day 0.21645
Adjusted Total Nurse Staffing Hours per Resident per Day 4.17321
Cycle 1 Total Number of Health Deficiencies 15
Cycle 1 Number of Standard Health Deficiencies 14
Cycle 1 Number of Complaint Health Deficiencies 1
Cycle 1 Health Deficiency Score 104
Cycle 1 Standard Survey Health Date 05/12/2017
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 104
Cycle 2 Total Number of Health Deficiencies 25
Cycle 2 Number of Standard Health Deficiencies 24
Cycle 2 Number of Complaint Health Deficiencies 2
Cycle 2 Health Deficiency Score 128
Cycle 2 Standard Health Survey Date 05/13/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 128
Cycle 3 Total Number of Health Deficiencies 26
Cycle 3 Number of Standard Health Deficiencies 26
Cycle 3 Health Deficiency Score 152
Cycle 3 Standard Health Survey Date 03/16/2015
Cycle 3 Number of Health Revisits 2
Cycle 3 Health Revisit Score 76
Cycle 3 Total Health Score 228
Total Weighted Health Survey Score 132.667
Number of Facility Reported Incidents 2
Number of Substantiated Complaints 2
Number of Fines 1
Total Amount of Fines in Dollars $3097.00
Number of Payment Denials 1
Total Number of Penalties 2
Processing Date 08/01/2017

Owner or Manager · Golden Cross Health Care

Owner Name Role Association Date
1450 NORTH FAIR OAKS LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/12/2010
AREVALO, JOSE (Individual) MANAGING EMPLOYEE since 12/12/2010
MERCADO, JOSEMAR (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/12/2010

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