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Foss Home & Village - Seattle Nursing Home

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Federal Provider Number
505416
Provider Name
FOSS HOME & VILLAGE
Provider Address
13023 GREENWOOD AVENUE NORTH
SEATTLE, WA 98133
Provider Phone Number
(206) 364-1300
Provider SSA County
160
Provider County Name
King
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
211
Number of Residents in Certified Beds
149
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FOSS HOME
Date First Approved to Provide Medicare and Medicaid services
1992-01-01
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
3.12181
Reported LPN Staffing Hours per Resident per Day
0.39732
Reported RN Staffing Hours per Resident per Day
1.24060
Reported Licensed Staffing Hours per Resident per Day
1.63792
Reported Total Nurse Staffing Hours per Resident per Day
4.75973
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07248
Expected CNA Staffing Hours per Resident per Day
2.81133
Expected LPN Staffing Hours per Resident per Day
0.69595
Expected RN Staffing Hours per Resident per Day
1.12114
Expected Total Nurse Staffing Hours per Resident per Day
4.62843
Adjusted CNA Staffing Hours per Resident per Day
2.72468
Adjusted LPN Staffing Hours per Resident per Day
0.47385
Adjusted RN Staffing Hours per Resident per Day
0.82681
Adjusted Total Nurse Staffing Hours per Resident per Day
4.14525
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
7
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2015-04-13
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
108
Cycle 2 Standard Health Survey Date
2014-01-31
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
108
Cycle 3 Total Number of Health Deficiencies
18
Cycle 3 Number of Standard Health Deficiencies
17
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
92
Cycle 3 Standard Health Survey Date
2012-09-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
92
Total Weighted Health Survey Score
71.33300
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
13
Number of Fines
1
Total Amount of Fines in Dollars
1170
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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