Ida Culver House Broadview Ncc - Seattle Nursing Home

General Information

UPDATE
Federal Provider Number
505377
Provider Name
IDA CULVER HOUSE BROADVIEW NCC
Provider Address
12509 GREENWOOD AVENUE NORTH
SEATTLE, WA 98133
Provider Phone Number
2063611989
Provider SSA County
160
Provider County Name
King
Ownership Type
For profit - Partnership
Number of Certified Beds
74
Number of Residents in Certified Beds
69
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BROADVIEW DEVELOPMENT ASSOCIATES II LP
Date First Approved to Provide Medicare and Medicaid services
1991-05-06
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
2
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
3.34275
Reported LPN Staffing Hours per Resident per Day
0.59275
Reported RN Staffing Hours per Resident per Day
1.27899
Reported Licensed Staffing Hours per Resident per Day
1.87174
Reported Total Nurse Staffing Hours per Resident per Day
5.21449
Reported Physical Therapist Staffing Hours per Resident Per Day
0.30000
Expected CNA Staffing Hours per Resident per Day
2.65256
Expected LPN Staffing Hours per Resident per Day
0.64334
Expected RN Staffing Hours per Resident per Day
1.07575
Expected Total Nurse Staffing Hours per Resident per Day
4.37165
Adjusted CNA Staffing Hours per Resident per Day
3.09214
Adjusted LPN Staffing Hours per Resident per Day
0.76474
Adjusted RN Staffing Hours per Resident per Day
0.88837
Adjusted Total Nurse Staffing Hours per Resident per Day
4.80804
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-06-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
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
52
Cycle 2 Standard Health Survey Date
2013-03-20
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
4
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-01-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
28.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
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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