Healdsburg Senior Living Community - Healdsburg Nursing Home
General Information
UPDATEFederal Provider Number
555820
Provider Name
HEALDSBURG SENIOR LIVING COMMUNITY
Provider Address
725 GROVE STREET
HEALDSBURG, CA 95448
HEALDSBURG, CA 95448
Provider Phone Number
(707) 433-4877
Provider SSA County
590
Provider County Name
Sonoma
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
38
Number of Residents in Certified Beds
31
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BERRYMAN HEALTH, INC
Date First Approved to Provide Medicare and Medicaid services
2005-04-04
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
3
Health Inspection Rating Footnote
QM Rating
1
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
2.52581
Reported LPN Staffing Hours per Resident per Day
0.23548
Reported RN Staffing Hours per Resident per Day
1.49194
Reported Licensed Staffing Hours per Resident per Day
1.72742
Reported Total Nurse Staffing Hours per Resident per Day
4.25323
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06935
Expected CNA Staffing Hours per Resident per Day
2.38078
Expected LPN Staffing Hours per Resident per Day
0.61286
Expected RN Staffing Hours per Resident per Day
0.96708
Expected Total Nurse Staffing Hours per Resident per Day
3.96071
Adjusted CNA Staffing Hours per Resident per Day
2.60318
Adjusted LPN Staffing Hours per Resident per Day
0.31891
Adjusted RN Staffing Hours per Resident per Day
1.15273
Adjusted Total Nurse Staffing Hours per Resident per Day
4.32860
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2014-12-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-12-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-12-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
48.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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