Haven Of Flagstaff, Llc - Flagstaff Nursing Home
General Information
UPDATEFederal Provider Number
35091
Provider Name
HAVEN OF FLAGSTAFF, LLC
Provider Address
800 WEST UNIVERSITY AVENUE
FLAGSTAFF, AZ 86001
FLAGSTAFF, AZ 86001
Provider Phone Number
9287796931
Provider SSA County
20
Provider County Name
Coconino
Ownership Type
For profit - Corporation
Number of Certified Beds
80
Number of Residents in Certified Beds
51
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HAVEN OF FLAGSTAFF LLC
Date First Approved to Provide Medicare and Medicaid services
1984-02-08
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
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
2.49314
Reported LPN Staffing Hours per Resident per Day
0.76275
Reported RN Staffing Hours per Resident per Day
1.01667
Reported Licensed Staffing Hours per Resident per Day
1.77941
Reported Total Nurse Staffing Hours per Resident per Day
4.27256
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10196
Expected CNA Staffing Hours per Resident per Day
2.29549
Expected LPN Staffing Hours per Resident per Day
0.58705
Expected RN Staffing Hours per Resident per Day
0.97064
Expected Total Nurse Staffing Hours per Resident per Day
3.85319
Adjusted CNA Staffing Hours per Resident per Day
2.66497
Adjusted LPN Staffing Hours per Resident per Day
1.07841
Adjusted RN Staffing Hours per Resident per Day
0.78263
Adjusted Total Nurse Staffing Hours per Resident per Day
4.46961
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-05-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-03-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
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
2011-12-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
25.33300
Number of Facility Reported Incidents
0
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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