Washington Nursing Homes >> Dayton Nursing Homes >> Booker Rest Home Annex

Booker Rest Home Annex - Dayton Nursing Home

General Information

UPDATE
Federal Provider Number
505437
Provider Name
BOOKER REST HOME ANNEX
Provider Address
1012 SOUTH 3RD STREET
DAYTON, WA 99328
Provider Phone Number
5093823212
Provider SSA County
60
Provider County Name
Columbia
Ownership Type
Non profit - Other
Number of Certified Beds
34
Number of Residents in Certified Beds
29
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1992-01-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.73103
Reported LPN Staffing Hours per Resident per Day
0.13103
Reported RN Staffing Hours per Resident per Day
1.36724
Reported Licensed Staffing Hours per Resident per Day
1.49828
Reported Total Nurse Staffing Hours per Resident per Day
4.22930
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02414
Expected CNA Staffing Hours per Resident per Day
2.38089
Expected LPN Staffing Hours per Resident per Day
0.53256
Expected RN Staffing Hours per Resident per Day
0.73399
Expected Total Nurse Staffing Hours per Resident per Day
3.64744
Adjusted CNA Staffing Hours per Resident per Day
2.81454
Adjusted LPN Staffing Hours per Resident per Day
0.20421
Adjusted RN Staffing Hours per Resident per Day
1.39185
Adjusted Total Nurse Staffing Hours per Resident per Day
4.67393
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2014-08-21
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
34
Cycle 1 Total Health Score
102
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-07-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-05-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
55.66700
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
2
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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