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Everett Transitional Care Serv - Everett Nursing Home

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Federal Provider Number
505505
Provider Name
EVERETT TRANSITIONAL CARE SERV
Provider Address
916 PACIFIC AVENUE - 6TH FLOOR
EVERETT, WA 98201
Provider Phone Number
(425) 258-7552
Provider SSA County
300
Provider County Name
Snohomish
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
31
Number of Residents in Certified Beds
28
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EVERETT TRANSITIONAL CARE SERVICES
Date First Approved to Provide Medicare and Medicaid services
1997-09-18
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
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
2.96429
Reported LPN Staffing Hours per Resident per Day
0.91786
Reported RN Staffing Hours per Resident per Day
2.63214
Reported Licensed Staffing Hours per Resident per Day
3.55000
Reported Total Nurse Staffing Hours per Resident per Day
6.51429
Reported Physical Therapist Staffing Hours per Resident Per Day
0.57143
Expected CNA Staffing Hours per Resident per Day
2.62813
Expected LPN Staffing Hours per Resident per Day
0.97631
Expected RN Staffing Hours per Resident per Day
2.13644
Expected Total Nurse Staffing Hours per Resident per Day
5.74087
Adjusted CNA Staffing Hours per Resident per Day
2.76755
Adjusted LPN Staffing Hours per Resident per Day
0.78031
Adjusted RN Staffing Hours per Resident per Day
0.92057
Adjusted Total Nurse Staffing Hours per Resident per Day
4.57395
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-11-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2014-01-10
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
18
Cycle 3 Number of Standard Health Deficiencies
15
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
132
Cycle 3 Standard Health Survey Date
2012-09-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
132
Total Weighted Health Survey Score
48.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
5
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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