Life Care Center Of The San Juan Islands - Friday Harbor Nursing Home
General Information
UPDATEFederal Provider Number
505332
Provider Name
LIFE CARE CENTER OF THE SAN JUAN ISLANDS
Provider Address
660 SPRING STREET
FRIDAY HARBOR, WA 98250
FRIDAY HARBOR, WA 98250
Provider Phone Number
3603782117
Provider SSA County
270
Provider County Name
San Juan
Ownership Type
For profit - Corporation
Number of Certified Beds
85
Number of Residents in Certified Beds
45
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CASCADE MEDICAL INVESTORS LIMITED PARTNERSHIP
Date First Approved to Provide Medicare and Medicaid services
1989-03-01
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
4
Overall Rating Footnote
Health Inspection Rating
2
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
2.07889
Reported LPN Staffing Hours per Resident per Day
0.46556
Reported RN Staffing Hours per Resident per Day
1.08111
Reported Licensed Staffing Hours per Resident per Day
1.54667
Reported Total Nurse Staffing Hours per Resident per Day
3.62556
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14556
Expected CNA Staffing Hours per Resident per Day
2.22707
Expected LPN Staffing Hours per Resident per Day
0.54632
Expected RN Staffing Hours per Resident per Day
0.85806
Expected Total Nurse Staffing Hours per Resident per Day
3.63146
Adjusted CNA Staffing Hours per Resident per Day
2.29044
Adjusted LPN Staffing Hours per Resident per Day
0.70730
Adjusted RN Staffing Hours per Resident per Day
0.94143
Adjusted Total Nurse Staffing Hours per Resident per Day
4.02435
Cycle 1 Total Number of Health Deficiencies
24
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
10
Cycle 1 Health Deficiency Score
88
Cycle 1 Standard Survey Health Date
2015-02-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
88
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2014-03-21
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
9
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
7
Cycle 3 Health Deficiency Score
169
Cycle 3 Standard Health Survey Date
2013-02-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
169
Total Weighted Health Survey Score
84.16700
Number of Facility Reported Incidents
12
Number of Substantiated Complaints
10
Number of Fines
1
Total Amount of Fines in Dollars
3500
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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