Josephine Sunset Home - Stanwood Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
505465
Provider Name
JOSEPHINE SUNSET HOME
Provider Address
9901 272ND PLACE NORTHWEST
STANWOOD, WA 98292
STANWOOD, WA 98292
Provider Phone Number
(360) 629-2126
Provider SSA County
300
Provider County Name
Snohomish
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
160
Number of Residents in Certified Beds
160
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
JOSEPHINE SUNSET HOME INC
Date First Approved to Provide Medicare and Medicaid services
1992-01-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.55875
Reported LPN Staffing Hours per Resident per Day
0.88969
Reported RN Staffing Hours per Resident per Day
0.94500
Reported Licensed Staffing Hours per Resident per Day
1.83469
Reported Total Nurse Staffing Hours per Resident per Day
4.39344
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07188
Expected CNA Staffing Hours per Resident per Day
2.76426
Expected LPN Staffing Hours per Resident per Day
0.69062
Expected RN Staffing Hours per Resident per Day
1.11516
Expected Total Nurse Staffing Hours per Resident per Day
4.57004
Adjusted CNA Staffing Hours per Resident per Day
2.27128
Adjusted LPN Staffing Hours per Resident per Day
1.06925
Adjusted RN Staffing Hours per Resident per Day
0.63319
Adjusted Total Nurse Staffing Hours per Resident per Day
3.87514
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2015-01-09
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
2
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2014-02-04
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
10
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2012-11-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
30.66700
Number of Facility Reported Incidents
6
Number of Substantiated Complaints
5
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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