PROVIDENCE HOLY CROSS MED CTR D/P SNF
11600A INDIAN HILLS ROAD, MISSION HILLS, CA 91345
MISSION HILLS, CA, 91345
8188984630
CCN: 555074
1
Overall1
Health4
Staffing3
QualitySpecial FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
OIG Federal Exclusion Matches (3)
This facility's name matches one or more entities on the OIG List of Excluded Individuals/Entities (LEIE). Excluded parties are prohibited from participation in Medicare and Medicaid programs.
PROVIDENT HOME HEALTH CARE SER
1128b7
Excluded 2005-06-01
SOUTHERN CALIFORNIA CARDIOLOGY
1128b8
Excluded 2004-08-19
SOUTHERN CALIFORNIA RESPIRATOR
1128b8
Excluded 2005-06-20
Ownership
| Name | Role | % |
|---|---|---|
| PROVIDENCE HEALTH SYSTEM-SOUTHERN CALIFORNIA | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% |
| LYONS, MARY | CORPORATE DIRECTOR | NOT APPLICABLE |
| MARKHAM, DONNA | CORPORATE DIRECTOR | NOT APPLICABLE |
| MURPHY, MICHAEL | CORPORATE DIRECTOR | NOT APPLICABLE |
| O'QUINN, MARVIN | CORPORATE DIRECTOR | NOT APPLICABLE |
| PACINI, CAROL | CORPORATE DIRECTOR | NOT APPLICABLE |
| SORENSON, CHARLES | CORPORATE DIRECTOR | NOT APPLICABLE |
| SPRUNK, ERIC | CORPORATE DIRECTOR | NOT APPLICABLE |
| KINGSTON, MARY BETH | CORPORATE DIRECTOR | NOT APPLICABLE |
| BLAIR, RICHARD | CORPORATE DIRECTOR | NOT APPLICABLE |
| CRAWFORD, ISIAAH | CORPORATE DIRECTOR | NOT APPLICABLE |
| HEJNA, DIANE | CORPORATE DIRECTOR | NOT APPLICABLE |
| HUGHES, PHYLLIS | CORPORATE DIRECTOR | NOT APPLICABLE |
| WATSON, JAMES | CORPORATE OFFICER | NOT APPLICABLE |
| ANDERSON, DONALD | CORPORATE OFFICER | NOT APPLICABLE |
| HOFFMAN, GREGORY | CORPORATE OFFICER | NOT APPLICABLE |
| MARTIN, JAMES | CORPORATE OFFICER | NOT APPLICABLE |
| NEWSOM, ANNA | CORPORATE OFFICER | NOT APPLICABLE |
| WEXLER, ERIK | CORPORATE OFFICER | NOT APPLICABLE |
| PROVIDENCE HEALTH & SERVICES - WASHINGTON | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| KLEIN, BERNARD | W-2 MANAGING EMPLOYEE | NOT APPLICABLE |
| PICKETT-LYONS, GLENDA | W-2 MANAGING EMPLOYEE | NOT APPLICABLE |
| ROHAN, TIMOTHY | W-2 MANAGING EMPLOYEE | NOT APPLICABLE |
| SANI, SASAN | W-2 MANAGING EMPLOYEE | NOT APPLICABLE |
Penalties (2)
| Date | Type | Amount |
|---|---|---|
| 2024-04-14 | Fine | $98K |
| 2023-03-26 | Fine | $10K |
Health Deficiencies (49)
2025-12-11 · Health
K
F695 · Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
2025-03-27 · Health
D
F883 · Infection Control Deficiencies
Develop and implement policies and procedures for flu and pneumonia vaccinations.
D
F881 · Infection Control Deficiencies
Implement a program that monitors antibiotic use.
E
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
F
F835 · Administration Deficiencies
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
E
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
F761 · Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
E
F760 · Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
D
F757 · Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
E
F695 · Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
E
F693 · Quality of Life and Care Deficiencies
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
D
F690 · Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
E
F658 · Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
B
F641 · Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
D
F604 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
D
F558 · Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
D
F552 · Resident Rights Deficiencies
Ensure that residents are fully informed and understand their health status, care and treatments.
D
F550 · Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
2024-04-14 · Health
E
F881 · Infection Control Deficiencies
Implement a program that monitors antibiotic use.
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
E
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
F758 · Pharmacy Service Deficiencies
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
D
F755 · Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
E
F700 · Quality of Life and Care Deficiencies
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
D
F695 · Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
D
F694 · Quality of Life and Care Deficiencies
Provide for the safe, appropriate administration of IV fluids for a resident when needed.
E
F693 · Quality of Life and Care Deficiencies
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
G
F690 · Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
E
F686 · Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
E
F656 · Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
B
F641 · Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
B
F640 · Resident Assessment and Care Planning Deficiencies
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
E
F604 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
G
F580 · Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
D
F550 · Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
2023-09-29 · Health
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
2023-03-26 · Health
E
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
F825 · Quality of Life and Care Deficiencies
Provide or get specialized rehabilitative services as required for a resident.
E
F761 · Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
D
F757 · Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
D
F755 · Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
E
F693 · Quality of Life and Care Deficiencies
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
D
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
F688 · Quality of Life and Care Deficiencies
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
E
F686 · Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
D
F656 · Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
D
F604 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
E
F578 · Resident Rights Deficiencies
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
E
F577 · Resident Rights Deficiencies
Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day3.68
9.68
RN Hrs/Resident/Day0.54
3.85
LPN Hrs/Resident/Day0.81
1.06
CNA Hrs/Resident/Day2.33
4.77
PT Hrs/Resident/Day0.12
0.00
Data as of 2026-03-01