Empres Post Acute Rehabilitation - Petaluma Nursing Home
General Information
UPDATEFederal Provider Number
56120
Provider Name
EMPRES POST ACUTE REHABILITATION
Provider Address
300 DOUGLAS STREET
PETALUMA, CA 94952
PETALUMA, CA 94952
Provider Phone Number
(707) 763-6887
Provider SSA County
590
Provider County Name
Sonoma
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
98
Number of Residents in Certified Beds
88
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1969-11-10
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.55568
Reported LPN Staffing Hours per Resident per Day
0.71932
Reported RN Staffing Hours per Resident per Day
0.36932
Reported Licensed Staffing Hours per Resident per Day
1.08864
Reported Total Nurse Staffing Hours per Resident per Day
3.64432
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14773
Expected CNA Staffing Hours per Resident per Day
2.49851
Expected LPN Staffing Hours per Resident per Day
0.54585
Expected RN Staffing Hours per Resident per Day
0.80241
Expected Total Nurse Staffing Hours per Resident per Day
3.84677
Adjusted CNA Staffing Hours per Resident per Day
2.50985
Adjusted LPN Staffing Hours per Resident per Day
1.09377
Adjusted RN Staffing Hours per Resident per Day
0.34391
Adjusted Total Nurse Staffing Hours per Resident per Day
3.81876
Cycle 1 Total Number of Health Deficiencies
18
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
9
Cycle 1 Health Deficiency Score
120
Cycle 1 Standard Survey Health Date
2015-03-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
120
Cycle 2 Total Number of Health Deficiencies
20
Cycle 2 Number of Standard Health Deficiencies
18
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
128
Cycle 2 Standard Health Survey Date
2014-02-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
128
Cycle 3 Total Number of Health Deficiencies
16
Cycle 3 Number of Standard Health Deficiencies
15
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
128
Cycle 3 Standard Health Survey Date
2013-07-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
128
Total Weighted Health Survey Score
124.00000
Number of Facility Reported Incidents
15
Number of Substantiated Complaints
10
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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