PACIFICA HOSPITAL OF THE VALLEY - SUN VALLEY, CA
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PACIFICA HOSPITAL OF THE VALLEY
9449 SAN FERNANDO RD SUN VALLEY, CA 91352 RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTIONS SNF/NF (DUALLY CERTIFIED) Services provided by PACIFICA HOSPITAL OF THE VALLEY:
Beds - Total (Total number of beds in a facility, including those in non-Participating or non-licensed areas): 81 Beds - Total certified (Number of beds in Medicare and/or Medicaid certified areas within a facility): 81 Lpn/lvn - Full time (The number of full-time equivalent licensed practical/ vocational nurses employed by a facility on a full time basis): 56.80 Registered nurse - Full time (The number of full-time equivalent registered nurses employed by a facility on a full time basis): 14.40 Change of ownership counter (The number of times a change of ownership (chow) has taken place for a particular provider): 4 Prior change of ownership (The date of a prior change of ownership): Jan 1994 Program participation (Indicates if the provider participates in Medicare, Medicaid, or both programs): MEDICARE AND MEDICAID Regional override #1 (number beds) (This field is set to "y" when the regional office has to ok a pending record in the special fields screen. this field only applies to categories in the odie data entry system): Yes Related provider number (This field is used when a provider's facility contains more than one distinct provider,such as a hospital with distinct part long term care. the number in this field will be the provider nmbr of the highest level of care): 050378 Activity professional - Full time (The number of full-time equivalent activities professionals employed full time by a facility): 1.14 Administrator - Part time (The number of full-time equivalent administrative staff employed on a part-time basis by a facility): 0.57 Beds - Snf/nf (Number of beds certified for both Medicare and Medicaid skilled nursing care in a long term care facility): 81 Cert nurse aides - Full time (The number of full-time equivalent certified nurse aides employed by a facility on a full time basis): 24.34 Dietitians - Full time (The number of full-time equivalent dietitians employed by a facility on a full time basis): 1.14 Dietitians - Part time (The number of full-time equivalent dietitians employed by a facility on a part time basis): 0.57 Food service - Part time (The number of full-time equivalent food service personnel employed by a facility on a part time basis): 1.71 Housekeeping - Full time (The number of full-time equivalent housekeeping personnel employed by a facility on a full time basis): 4.57 Medical director - Contract (The number of full-time equivalent medical directors under contrcat to a facility): 0.57 Medical director - Part time (The number of full-time equivalent medical directors employed by a facility on a part time basis): 0.57 Occupational therapist - Full time (The number of full-time equivalent occupational therapists employed by a facility on a full time basis): 1.14 Occupational therapist - Part time (The number of full-time equivalent occupational therapists employed by a facility on a part time basis): 0.23 Other - Full time (The number of full-time equivalent persons not included in any other categories employed by the facility on a full-time basis): 1.14 Other activities staff-Full time (Number of full-time staff hours for other activities): 1.14 Othr social serv staff-Full time (Number of full-time staff hours provided by other socia l services staff): 0.34 Pharmacists - Full time (The number of full-time equivalent pharmacists employed by a facility on a full time basis): 0.34 Pharmacists - Part time (The number of full-time equivalent pharmacists employed by a facility on a part time basis): 0.23 Physical therapists - Full time (The number of full time equivalent physical therapists employed by a facility on a full time basis): 0.57 Physical therapists - Part time (The number of full-time equivalent physical therapists employed by a facility on a part time basis): 0.57 Provider based facility (Indicates if a long term care facility is provider based): Yes Rn director of nursing - Full time (The number of full-time equivalent rn director of nursing employed by a facility on a full time basis): 2.29 Social worker - Full time (The number of full-time equivalent social workers employed by a facility on a full time basis): 2.29 Speech pathologist - Part time (The number of full-time equivalent speech pathologists employed by a facility on a part time basis): 0.86 Ther rec spec - Contract (Number of contract staff hours provided by therapeutic recreation specialist): 0.36 Ther rec spec - Full time (Number of full-time staff hours provided by therapeutic recreation specialist): 3.43 Ther rec spec - Part time (Number of part-time staff hours provided by therapeutic recreation specialist): 0.91 Compliance: plan of correction (Indicates if a provider is in compliance with program requirements based on an acceptable plan for correction of deficiencies): COMPLIANCE BASED ON ACCEPTABLE POC Compliance: status (Indicates if a provider or supplier is in compliance with program requirements): IN COMPLIANCE Current survey date (The date of the health or life safety code survey, whichever is later. the "official" survey date for the provider): Nov 2001 Eligibility code (Indicates if a facility is eligible to participate in the Medicare and/or Medicaid programs): ELIGIBLE TO PARTICIPATE |
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