Southern California Hosp At Culver City D/p Snf
3828 Delmas Terrace, Culver City, CA 90230


Southern California Hosp At Culver City D/p Snf is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 555874. The address is 3828 Delmas Terrace, Culver City, CA 90230. The zip code is 90230. The phone number is 3238367000.


Southern California Hosp At Culver City D/p Snf · 3828 Delmas Terrace, Culver City, CA 90230

Federal Provider Number 555874
Provider Name SOUTHERN CALIFORNIA HOSP AT CULVER CITY D/P SNF
Address 3828 DELMAS TERRACE
CULVER CITY, CA 90230
Phone Number 3238367000
SSA County Code 200
County Name Los Angeles
Ownership Type For profit - Corporation
Certified Beds 21
Certified Beds Residents 17
Provider Type Medicare and Medicaid
Resides in Hospital true
Legal Business Name SOUTHERN CALIFORNIA HEALTHCARE SYSTEM, INC
Date First Approved to Provide Medicare Medicaid Services 06/29/2012
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 Both
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 4
Health Inspection Rating 3
Quality Measure Rating 2
Staffing Rating 4
RN Staffing Rating 5
Reported CNA Staffing Hours per Resident per Day 2.24706
Reported LPN Staffing Hours per Resident per Day 1.31176
Reported RN Staffing Hours per Resident per Day 3.47059
Reported Licensed Staffing Hours per Resident per Day 4.78235
Reported Total Nurse Staffing Hours per Resident per Day 7.02941
Reported Physical Therapist Staffing Hours per Resident Per Day 0.33529
Expected CNA Staffing Hours per Resident per Day 3.01478
Expected LPN Staffing Hours per Resident per Day 1.41455
Expected RN Staffing Hours per Resident per Day 2.24073
Expected Total Nurse Staffing Hours per Resident per Day 6.67006
Adjusted CNA Staffing Hours per Resident per Day 1.82886
Adjusted LPN Staffing Hours per Resident per Day 0.76968
Adjusted RN Staffing Hours per Resident per Day 1.15731
Adjusted Total Nurse Staffing Hours per Resident per Day 4.24807
Cycle 1 Total Number of Health Deficiencies 8
Cycle 1 Number of Standard Health Deficiencies 6
Cycle 1 Number of Complaint Health Deficiencies 2
Cycle 1 Health Deficiency Score 40
Cycle 1 Standard Survey Health Date 10/09/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 40
Cycle 2 Total Number of Health Deficiencies 14
Cycle 2 Number of Standard Health Deficiencies 13
Cycle 2 Number of Complaint Health Deficiencies 1
Cycle 2 Health Deficiency Score 80
Cycle 2 Standard Health Survey Date 06/20/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 80
Cycle 3 Total Number of Health Deficiencies 6
Cycle 3 Number of Standard Health Deficiencies 5
Cycle 3 Number of Complaint Health Deficiencies 1
Cycle 3 Health Deficiency Score 32
Cycle 3 Standard Health Survey Date 03/09/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 32
Total Weighted Health Survey Score 52
Number of Substantiated Complaints 1
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Southern California Hosp At Culver City D/p Snf

Owner Name Role Association Date
ALTA HOSPITALS SYSTEM LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/31/2012
CHE, JULIE (Individual) MANAGING EMPLOYEE since 12/31/2012
CHUNG, CHI-KUO (Individual) MANAGING EMPLOYEE since 03/21/2016
FOWLER, STACY (Individual) MANAGING EMPLOYEE since 09/19/2016
FRAZIER, KIMBERLY (Individual) MANAGING EMPLOYEE since 04/24/2017
GORENSTEIN, WILLIAM (Individual) OFFICER since 08/15/2016
GREEN EQUITY INVESTORS SIDE V LP (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/31/2012
GREEN EQUITY INVESTORS V LP (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/31/2012
IVY HOLDINGS INC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/31/2012
IVY INTERMEDIATE HOLDING INC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/31/2012
JPMORGAN CHASE BANK, NATIONAL ASSOCIATION (Organization) 5% OR GREATER SECURITY INTEREST since 06/30/2016
LEE, SAMUEL (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/31/2012
LEE, SAMUEL (Individual) DIRECTOR since 12/31/2012
LEE, SAMUEL (Individual) OFFICER since 12/31/2012
MAASS, JUDITH (Individual) MANAGING EMPLOYEE since 03/16/2015
MARTEL, ROCHELLE (Individual) MANAGING EMPLOYEE since 12/31/2012
PHILLIPS, MICHAEL (Individual) MANAGING EMPLOYEE since 11/18/2014
PROSPECT MEDICAL HOLDINGS INC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/31/2012
REDIN, JEREMY (Individual) OFFICER since 12/31/2012
SHIN, ELLEN (Individual) OFFICER since 12/31/2012
TOPPER, DAVID (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/31/2012
TOPPER, DAVID (Individual) DIRECTOR since 12/31/2012
TOPPER, DAVID (Individual) OFFICER since 12/31/2012

90230 · Nursing Home

Marycrest Manor 10664 St. James Drive, Culver City, CA 90230
Marina Pointe Healthcare & Subacute 5240 Sepulveda Blvd, Culver City, CA 90230

Culver City · Nursing Home

Marycrest Manor 10664 St. James Drive, Culver City, CA 90230
Marina Pointe Healthcare & Subacute 5240 Sepulveda Blvd, Culver City, CA 90230

CA · Nursing Home

Mission Carmichael Healthcare Center 3630 Mission Avenue, Carmichael, CA 95608
Yuba City Post Acute 1220 Plumas St, Yuba City, CA 95991
Vineyard Hills Health Center 290 Heather Ct, Templeton, CA 93465
Fairview Developmental Center 2501 Harbor Boulevard, Costa Mesa, CA 92626
Providence Little Comp of Mary Subacute Care Ctr 1322 West Sixth Street, San Pedro, CA 90732
View Park Conv Hosp 3737 Don Felipe Drive, Los Angeles, CA 90008
Cottonwood Post-acute Rehab 625 Cottonwood Street, Woodland, CA 95695
Country Oaks Care Center 830 E Chapel St, Santa Maria, CA 93454
Villa Oaks Convalescent Hopital 1515 N.fair Oaks Avenue, Pasadena, CA 91103
Rancho Mirage Health and Rehabilitation Center 39950 Vista Del Sol, Rancho Mirage, CA 92270
Crenshaw Nursing Home 1900 S Longwood Ave, Los Angeles, CA 90016
San Luis Care Center 709 N Street, Newman, CA 95360
Inglewood Health Care Center 100 S. Hillcrest Blvd, Inglewood, CA 90301
Marian Medical Center D/p Snf 1530 E Cypress Wy, Santa Maria, CA 93454
Brookside Healthcare Center 105 Terracina Blvd., Redlands, CA 92373
Sunnyside Conv. Hospital 2939 S. Peach Avenue, Fresno, CA 93725
California Convalescent Center 1 909 S Lake Street, Los Angeles, CA 90006
Redlands Comm Hosp D/p Snf 350 Terracina Blvd., Redlands, CA 92373
Seaview Rehabilitation & Wellness Center, Lp 6400 Purdue Drive, Eureka, CA 95503
Santa Monica Conv Ctr II 2250 29th Street, Santa Monica, CA 90405
Catalina Island Medical Center D/p Snf 100 Falls Canyon Rd, Avalon, CA 90704
Greenridge Senior Care 2150 Pyramid Drive, El Sobrante, CA 94803
San Jose Healthcare & Wellness Center 75 N. 13th Street, San Jose, CA 95112
Rock Creek Care Center 260 Racetrack Street, Auburn, CA 95603
Alta Vista Healthcare & Wellness Centre 9020 Garfield Street, Riverside, CA 92503
Harbor Post Acute Care Center 21521 S. Vermont Avenue, Torrance, CA 90502
Cherry Valley Healthcare 5800 West Wilson Street, Banning, CA 92220
Merced Nursing & Rehabilitation Ctr 510 West 26th Street, Merced, CA 95340
Sierra Vista Healthcare 1715 South Cedar, Fresno, CA 93702
Simi Valley Care Center 5270 E Los Angeles Ave, Simi Valley, CA 93063
Villa Mesa Care Center 867 E. 11th Street, Upland, CA 91786
Gladstone Care and Rehabilitat 435 E. Gladstone Avenue, Glendora, CA 91740
Los Altos Sub-acute and Rehabilitation Center 809 Fremont Avenue, Los Altos, CA 94024
Pacific Palms Healthcare 1020 Termino Avenue, Long Beach, CA 90804
Briarwood Post Acute 5901 Lemon Hill Ave, Sacramento, CA 95824
Totally Kids Rehabilitation Hospital - D/p Snf 1720 Mountain View, Loma Linda, CA 92354
Healdsburg Senior Living Community 725 Grove Street, Healdsburg, CA 95448
Poway Healthcare Center 15632 Pomerado Road, Poway, CA 92064
Golden Cross Health Care 1450 N. Fair Oaks Avenue, Pasadena, CA 91103
Grand Terrace Care Center 12000 Mt Vernon Avenue, Grand Terrace, CA 92313