Golden Livingcenter - Petaluma - Petaluma Nursing Home
General Information
UPDATEFederal Provider Number
555120
Provider Name
GOLDEN LIVINGCENTER - PETALUMA
Provider Address
101 MONROE STREET
PETALUMA, CA 94954
PETALUMA, CA 94954
Provider Phone Number
(707) 763-4109
Provider SSA County
590
Provider County Name
Sonoma
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
99
Number of Residents in Certified Beds
94
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BEVERLY HEALTH AND REHABILITATION SERVICES, INC
Date First Approved to Provide Medicare and Medicaid services
1980-11-07
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
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
2.26809
Reported LPN Staffing Hours per Resident per Day
0.33883
Reported RN Staffing Hours per Resident per Day
1.02181
Reported Licensed Staffing Hours per Resident per Day
1.36064
Reported Total Nurse Staffing Hours per Resident per Day
3.62873
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03032
Expected CNA Staffing Hours per Resident per Day
2.38278
Expected LPN Staffing Hours per Resident per Day
0.54564
Expected RN Staffing Hours per Resident per Day
0.86769
Expected Total Nurse Staffing Hours per Resident per Day
3.79612
Adjusted CNA Staffing Hours per Resident per Day
2.33559
Adjusted LPN Staffing Hours per Resident per Day
0.51541
Adjusted RN Staffing Hours per Resident per Day
0.87991
Adjusted Total Nurse Staffing Hours per Resident per Day
3.85316
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2014-10-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
80
Cycle 2 Total Number of Health Deficiencies
17
Cycle 2 Number of Standard Health Deficiencies
17
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
144
Cycle 2 Standard Health Survey Date
2013-09-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
144
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-08-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
91.33300
Number of Facility Reported Incidents
9
Number of Substantiated Complaints
6
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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