Broadway Villa Post Acute - Sonoma Nursing Home
General Information
UPDATEFederal Provider Number
55987
Provider Name
BROADWAY VILLA POST ACUTE
Provider Address
1250 BROADWAY
SONOMA, CA 95476
SONOMA, CA 95476
Provider Phone Number
(707) 938-8406
Provider SSA County
590
Provider County Name
Sonoma
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
144
Number of Residents in Certified Beds
112
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ENSIGN SONOMA LLC
Date First Approved to Provide Medicare and Medicaid services
1974-07-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.90938
Reported LPN Staffing Hours per Resident per Day
0.61027
Reported RN Staffing Hours per Resident per Day
0.81205
Reported Licensed Staffing Hours per Resident per Day
1.42232
Reported Total Nurse Staffing Hours per Resident per Day
4.33170
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05402
Expected CNA Staffing Hours per Resident per Day
2.36079
Expected LPN Staffing Hours per Resident per Day
0.60923
Expected RN Staffing Hours per Resident per Day
0.90513
Expected Total Nurse Staffing Hours per Resident per Day
3.87515
Adjusted CNA Staffing Hours per Resident per Day
3.02388
Adjusted LPN Staffing Hours per Resident per Day
0.83142
Adjusted RN Staffing Hours per Resident per Day
0.67036
Adjusted Total Nurse Staffing Hours per Resident per Day
4.50580
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
84
Cycle 1 Standard Survey Health Date
2014-06-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
84
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-04-18
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
28
Cycle 3 Number of Standard Health Deficiencies
25
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
192
Cycle 3 Standard Health Survey Date
2012-05-23
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
96
Cycle 3 Total Health Score
288
Total Weighted Health Survey Score
104.66700
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
6
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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