Brookdale Fountaingrove - Santa Rosa Nursing Home
General Information
UPDATEFederal Provider Number
555836
Provider Name
BROOKDALE FOUNTAINGROVE
Provider Address
300 FOUNTAINGROVE PARKWAY
SANTA ROSA, CA 95403
SANTA ROSA, CA 95403
Provider Phone Number
(707) 566-8600
Provider SSA County
590
Provider County Name
Sonoma
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
45
Number of Residents in Certified Beds
33
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
EMERICARE INC
Date First Approved to Provide Medicare and Medicaid services
2007-01-02
Continuing Care Retirement Community
Y
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
2
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
3.18182
Reported LPN Staffing Hours per Resident per Day
0.78788
Reported RN Staffing Hours per Resident per Day
1.30758
Reported Licensed Staffing Hours per Resident per Day
2.09545
Reported Total Nurse Staffing Hours per Resident per Day
5.27728
Reported Physical Therapist Staffing Hours per Resident Per Day
0.17273
Expected CNA Staffing Hours per Resident per Day
2.60964
Expected LPN Staffing Hours per Resident per Day
0.70775
Expected RN Staffing Hours per Resident per Day
1.18056
Expected Total Nurse Staffing Hours per Resident per Day
4.49795
Adjusted CNA Staffing Hours per Resident per Day
2.99169
Adjusted LPN Staffing Hours per Resident per Day
0.92397
Adjusted RN Staffing Hours per Resident per Day
0.82759
Adjusted Total Nurse Staffing Hours per Resident per Day
4.72931
Cycle 1 Total Number of Health Deficiencies
18
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
96
Cycle 1 Standard Survey Health Date
2015-01-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
96
Cycle 2 Total Number of Health Deficiencies
22
Cycle 2 Number of Standard Health Deficiencies
19
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
116
Cycle 2 Standard Health Survey Date
2014-01-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
116
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2013-02-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
96.66700
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
15
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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