Fircrest Convalescent Hospital - Sebastopol Nursing Home
General Information
UPDATEFederal Provider Number
55476
Provider Name
FIRCREST CONVALESCENT HOSPITAL
Provider Address
7025 CORLINE COURT
SEBASTOPOL, CA 95472
SEBASTOPOL, CA 95472
Provider Phone Number
(707) 823-7444
Provider SSA County
590
Provider County Name
Sonoma
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
46
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SANDHYA INC.
Date First Approved to Provide Medicare and Medicaid services
1968-11-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
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
2.54239
Reported LPN Staffing Hours per Resident per Day
0.17500
Reported RN Staffing Hours per Resident per Day
1.38261
Reported Licensed Staffing Hours per Resident per Day
1.55761
Reported Total Nurse Staffing Hours per Resident per Day
4.10000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02283
Expected CNA Staffing Hours per Resident per Day
2.41593
Expected LPN Staffing Hours per Resident per Day
0.57068
Expected RN Staffing Hours per Resident per Day
0.86139
Expected Total Nurse Staffing Hours per Resident per Day
3.84800
Adjusted CNA Staffing Hours per Resident per Day
2.58213
Adjusted LPN Staffing Hours per Resident per Day
0.25452
Adjusted RN Staffing Hours per Resident per Day
1.19932
Adjusted Total Nurse Staffing Hours per Resident per Day
4.29487
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
84
Cycle 1 Standard Survey Health Date
2014-07-11
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
14
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
96
Cycle 2 Standard Health Survey Date
2013-08-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
96
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-07-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
82.66700
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
0
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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