Enumclaw Health & Rehab Center - Enumclaw Nursing Home
General Information
UPDATEFederal Provider Number
505400
Provider Name
ENUMCLAW HEALTH & REHAB CENTER
Provider Address
2323 JENSEN STREET
ENUMCLAW, WA 98022
ENUMCLAW, WA 98022
Provider Phone Number
3608252541
Provider SSA County
160
Provider County Name
King
Ownership Type
For profit - Corporation
Number of Certified Beds
92
Number of Residents in Certified Beds
73
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EVERGREEN WASHINGTON HEALTHCARE ENUMCLAW, L.L.C.
Date First Approved to Provide Medicare and Medicaid services
1991-11-01
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
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
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.27192
Reported LPN Staffing Hours per Resident per Day
0.67534
Reported RN Staffing Hours per Resident per Day
0.78904
Reported Licensed Staffing Hours per Resident per Day
1.46438
Reported Total Nurse Staffing Hours per Resident per Day
3.73630
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09863
Expected CNA Staffing Hours per Resident per Day
2.63757
Expected LPN Staffing Hours per Resident per Day
0.66116
Expected RN Staffing Hours per Resident per Day
1.02266
Expected Total Nurse Staffing Hours per Resident per Day
4.32139
Adjusted CNA Staffing Hours per Resident per Day
2.11354
Adjusted LPN Staffing Hours per Resident per Day
0.84781
Adjusted RN Staffing Hours per Resident per Day
0.57651
Adjusted Total Nurse Staffing Hours per Resident per Day
3.48514
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
84
Cycle 1 Standard Survey Health Date
2014-03-20
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
16
Cycle 2 Number of Standard Health Deficiencies
16
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
88
Cycle 2 Standard Health Survey Date
2012-11-20
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
30
Cycle 3 Number of Standard Health Deficiencies
30
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
252
Cycle 3 Standard Health Survey Date
2011-10-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
252
Total Weighted Health Survey Score
113.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
975
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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