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Canterbury House - Auburn Nursing Home

General Information

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Federal Provider Number
505344
Provider Name
CANTERBURY HOUSE
Provider Address
502 29TH STREET SOUTHEAST
AUBURN, WA 98002
Provider Phone Number
(253) 939-0090
Provider SSA County
160
Provider County Name
King
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
96
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EVERGREEN WASHINGTON HEALTHCARE AUBURN, L.L.C.
Date First Approved to Provide Medicare and Medicaid services
1989-08-17
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
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.94583
Reported LPN Staffing Hours per Resident per Day
0.77969
Reported RN Staffing Hours per Resident per Day
0.58750
Reported Licensed Staffing Hours per Resident per Day
1.36719
Reported Total Nurse Staffing Hours per Resident per Day
3.31302
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11979
Expected CNA Staffing Hours per Resident per Day
2.38721
Expected LPN Staffing Hours per Resident per Day
0.62384
Expected RN Staffing Hours per Resident per Day
1.05841
Expected Total Nurse Staffing Hours per Resident per Day
4.06946
Adjusted CNA Staffing Hours per Resident per Day
2.00003
Adjusted LPN Staffing Hours per Resident per Day
1.03735
Adjusted RN Staffing Hours per Resident per Day
0.41476
Adjusted Total Nurse Staffing Hours per Resident per Day
3.28163
Cycle 1 Total Number of Health Deficiencies
19
Cycle 1 Number of Standard Health Deficiencies
18
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
96
Cycle 1 Standard Survey Health Date
2014-08-01
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
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-08-29
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
14
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
88
Cycle 3 Standard Health Survey Date
2012-05-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
88
Total Weighted Health Survey Score
76.00000
Number of Facility Reported Incidents
3
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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