Friends House - Santa Rosa Nursing Home
General Information
UPDATEFederal Provider Number
555168
Provider Name
FRIENDS HOUSE
Provider Address
684 BENICIA DRIVE
SANTA ROSA, CA 95409
SANTA ROSA, CA 95409
Provider Phone Number
(707) 538-0152
Provider SSA County
590
Provider County Name
Sonoma
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
34
Number of Residents in Certified Beds
20
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
FRIENDS ASSOC OF SERVICES FOR THE ELDERLY
Date First Approved to Provide Medicare and Medicaid services
1984-04-13
Continuing Care Retirement Community
Y
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
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
3.47250
Reported LPN Staffing Hours per Resident per Day
0.65250
Reported RN Staffing Hours per Resident per Day
1.78750
Reported Licensed Staffing Hours per Resident per Day
2.44000
Reported Total Nurse Staffing Hours per Resident per Day
5.91250
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14250
Expected CNA Staffing Hours per Resident per Day
2.47571
Expected LPN Staffing Hours per Resident per Day
0.61269
Expected RN Staffing Hours per Resident per Day
1.09962
Expected Total Nurse Staffing Hours per Resident per Day
4.18803
Adjusted CNA Staffing Hours per Resident per Day
3.44162
Adjusted LPN Staffing Hours per Resident per Day
0.88393
Adjusted RN Staffing Hours per Resident per Day
1.21462
Adjusted Total Nurse Staffing Hours per Resident per Day
5.69068
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-06-02
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
24
Cycle 1 Total Health Score
72
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2013-08-01
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
68
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
20
Cycle 3 Standard Health Survey Date
2013-01-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
62.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
1
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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