General Information: IMPERIAL CONVALESCENT HOSPITAL
Nursing home name IMPERIAL CONVALESCENT HOSPITAL
Address11926 LA MIRADA BLVD
LA MIRADA, CA 90638
Phone number (562) 943-7156
Located within a hospital No
Type of ownership For profit - Corporation
Owner operates multiple homesYes
Accept Medicare or Medicaid Medicare and Medicaid
Continue Care Retirement CommunityNo
Resident and family councils Resident
Certified number of beds 99
Total number of residents 85
Perc of occupied beds 85
Sprinkler status Yes
Number of Facility Reported Incidents0
Number of Substantiated Complaints1
Number of Fines0
Total Amount of Fines$0
Total Number of Penalties0
Total Number of Penalties0
Ratings Summary: IMPERIAL CONVALESCENT HOSPITAL
Overall rating 3
3
Nursing Home Staffing 4
4
Registered Nurses only 3
3
Health Inspections 2
2
Quality Measures 4
4
Nursing Home Staffing Info: IMPERIAL CONVALESCENT HOSPITAL
National AverageCalifornia AverageIMPERIAL CONVALESCENT HOSPITAL
Overall staff rating NA NA 4
4
Registered Nurses only rating NANA 3
3
Total Number of Residents NA NA 85
Total Number of Nurse Staff Hours per Resident per Day 4.11 hours 4.49 hours 3.94 hours
Total Number of Licensed Nurse Staff Hours per Resident per Day 1.64 hours 1.8 hours 1.51 hours
Registered Nurses Hours per Residents per Day 0.81 hours 0.88 hours 0.58 hours
Licensed Practical or Vacation Nurses Hours per Resident per Day 0.83 hours 0.92 hours 0.93 hours
Certified Nursing Assistants Hours per Residents per Day 2.47 hours 2.69 hours 2.43 hours
Physical Therapy Staffing Hours per Resident Per Day 0.1 hours 0.14 hours 0.07 hours
Health Survey: IMPERIAL CONVALESCENT HOSPITAL
Heath Survey Summary on 2013-07-26
Total Number of Health Deficiencies 8
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Heath Survey Summary on 2012-04-13
Total Number of Health Deficiencies 17
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Heath Survey Summary on 2010-12-23
Total Number of Health Deficiencies 4
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Health Survey Details: IMPERIAL CONVALESCENT HOSPITAL
Inspection Results: 07/26/2013
Corrected Deficiency Scope and Severity
09/09/2013 Provide housekeeping and maintenance services. Pattern/Minimal harm or potential for actual harm
09/09/2013 Ensure each resident receives an accurate assessment by a qualified health professional. Isolated/Minimal harm or potential for actual harm
09/09/2013 Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Isolated/Minimal harm or potential for actual harm
09/09/2013 Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. Isolated/Minimal harm or potential for actual harm
09/09/2013 Store, cook, and serve food in a safe and clean way. Pattern/Minimal harm or potential for actual harm
09/09/2013 Have a program that investigates, controls and keeps infection from spreading. Pattern/Minimal harm or potential for actual harm
09/09/2013 Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Pattern/Minimal harm or potential for actual harm
09/09/2013 Operate and provide services according to Federal, State, and local laws and professional standards. Pattern/Minimal harm or potential for actual harm
Inspection Results: 04/13/2012
Corrected Deficiency Scope and Severity
05/12/2012 Ensure services provided by the nursing facility meet professional standards of quality. Isolated/Minimal harm or potential for actual harm
05/12/2012 Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. Isolated/Minimal harm or potential for actual harm
05/12/2012 Properly care for residents needing special services, including: injections, colostomy, ureostomy, ileostomy, tracheostomy care, tracheal suctioning, respiratory care, foot care, and prostheses. Pattern/Minimal harm or potential for actual harm
05/12/2012 Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. Pattern/Minimal harm or potential for actual harm
05/12/2012 Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores. Pattern/Minimal harm or potential for actual harm
05/12/2012 Provide necessary care and services to maintain or improve the highest well being of each resident . Pattern/Minimal harm or potential for actual harm
05/12/2012 Keep the rate of medication errors (wrong drug, wrong dose, wrong time) to less than 5%. Pattern/Minimal harm or potential for actual harm
05/12/2012 Conduct initial and periodic assessments of each resident's functional capacity. Isolated/Minimal harm or potential for actual harm
05/12/2012 Provide housekeeping and maintenance services. Pattern/Potential for minimal harm
05/12/2012 Provide medically-related social services to help each resident achieve the highest possible quality of life. Isolated/Minimal harm or potential for actual harm
05/12/2012 Have a program that investigates, controls and keeps infection from spreading. Isolated/Minimal harm or potential for actual harm
05/12/2012 Reasonably accommodate the needs and preferences of each resident. Isolated/Minimal harm or potential for actual harm
05/12/2012 Provide care for residents in a way that maintains or improves their dignity and respect in full recognition of their individuality. Isolated/Minimal harm or potential for actual harm
05/12/2012 Ensure that residents are safe from serious medication errors. Isolated/Minimal harm or potential for actual harm
05/12/2012 Store, cook, and serve food in a safe and clean way. Pattern/Minimal harm or potential for actual harm
05/12/2012 Give or get specialized rehabilitative services per the patient's assessment or plan of care. Isolated/Minimal harm or potential for actual harm
05/12/2012 Provide activities to meet the interests and needs of each resident. Pattern/Minimal harm or potential for actual harm
Inspection Results: 12/23/2010
Corrected Deficiency Scope and Severity
01/28/2011 Provide housekeeping and maintenance services. Pattern/Minimal harm or potential for actual harm
01/28/2011 Provide necessary care and services to maintain or improve the highest well being of each resident . Isolated/Minimal harm or potential for actual harm
01/28/2011 Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. Pattern/Minimal harm or potential for actual harm
01/28/2011 Store, cook, and serve food in a safe and clean way. Widespread/Potential for minimal harm

Fire Safety Survey: IMPERIAL CONVALESCENT HOSPITAL
Fire Safety Survey Summary on 2013-07-26
Total Number of Fire SafetyDeficiencies 7
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2012-04-11
Total Number of Fire SafetyDeficiencies 4
Scope and Severity of most Severe Health Deficiency Isolated/Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2010-12-23
Total Number of Fire SafetyDeficiencies 3
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Fire Safety Survey: IMPERIAL CONVALESCENT HOSPITAL
Fire Safety Survey Results: 07/26/2013
Corrected Deficiency Severity
09/09/2013 Fire resistant room wall surfaces. Isolated/Minimal harm or potential for actual harm
09/09/2013 Corridor and hallway doors that block smoke. Isolated/Minimal harm or potential for actual harm
09/09/2013 Exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector. Isolated/Minimal harm or potential for actual harm
09/09/2013 Record of quarterly fire drills for each shift under varying conditions. Isolated/Minimal harm or potential for actual harm
09/09/2013 Exits that are free from obstructions and can be used at all times. Pattern/Minimal harm or potential for actual harm
09/09/2013 Other fire safety features required by fire safety codes. Isolated/Minimal harm or potential for actual harm
09/09/2013 Properly installed electrical wiring and equipment. Isolated/Minimal harm or potential for actual harm
Fire Safety Survey Results: 04/11/2012
Corrected Deficiency Severity
05/12/2012 Fire resistant room wall surfaces. Isolated/Minimal harm or potential for actual harm
05/12/2012 Corridor and hallway doors that block smoke. Isolated/Minimal harm or potential for actual harm
05/12/2012 Automatic sprinkler systems that have been maintained in working order. Isolated/Minimal harm or potential for actual harm
05/12/2012 Properly installed electrical wiring and equipment. Isolated/Minimal harm or potential for actual harm
Fire Safety Survey Results: 12/23/2010
Corrected Deficiency Severity
01/24/2011 Corridor and hallway doors that block smoke. Pattern/Minimal harm or potential for actual harm
01/24/2011 Properly located and lighted "Exit" signs. Pattern/Minimal harm or potential for actual harm
01/24/2011 A fire alarm system that can be heard throughout the facility. Pattern/Minimal harm or potential for actual harm

Resident Complaints: IMPERIAL CONVALESCENT HOSPITAL
Date Complaint Substantiated: 02/25/2014
CorrectedCategoryDeficiencySeverity
03/17/2014Provide a safe, clean, comfortable and home-like environment; and allow residents to use personal belongings to the extent possible. C

Quality Measures: IMPERIAL CONVALESCENT HOSPITAL
Quality Measures National Average California Average IMPERIAL CONVALESCENT HOSPITAL
Overall quality rating NA NA 4
4
Long-Stay Residents
Percent of Long Stay Residents Whose Need for Help with ADLs has Increased 15.4% 11.7% 12.6%
Percent of Long Stay Residents Who Self Report Moderate to Severe Pain 8.3% 5.9% 9.7%
Percent of High Risk Long Stay Residents With Pressure Ulcers 6.1% 6.2% 1.7%
Percent of Long Stay Residents Who Lose Too Much Weight 7.2% 5.8% 6.9%
Percent of Low Risk Long Stay Residents Who Lose Control of Their Bowel or Bladder 43.9% 45.3% 53.7%
Percent of Long Stay Residents with a Catheter Inserted and Left in Their Bladder 3.2% 3.3% 2.4%
Percent of Long Stay Residents With a Urinary Tract Infection 6.2% 5.3% 9.9%
Percent of Long Stay Residents Who Have Depressive Symptoms 6.3% 1.8% 0.0%
Percent of Long Stay Residents Who Were Physically Restrained 1.4% 2.1% 4.2%
Percent of Long Stay Residents Experiencing One or More Falls with Major Injury 3.2% 1.6% 1.3%
Percent of Long Stay Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine 92.7% 92.3% 91.0%
Percent of Long Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 94.3% 94.6% 99.6%
Percent of Long Stay Residents Who Received an Antipsychotic Medication 20.7% 16.5% 17.5%
Short-Stay Residents
Percent of Short Stay Residents Who Self Report Moderate to Severe Pain 19.2% 16.9% 20.1%
Percent of Short Stay Residents With Pressure Ulcers That Are New or Worsened 1.2% 0.9% 1.9%
Percent of Short Stay Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine 83.4% 81.1% 89.6%
Percent of Short Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 82.4% 79.8% 99.6%
Percent of Short Stay Residents Who Newly Received an Antipsychotic Medication 2.6% 2.0% 2.0%

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