Olympia Manor - Olympia Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
505515
Provider Name
OLYMPIA MANOR
Provider Address
1811 EAST 22ND AVENUE
OLYMPIA, WA 98501
OLYMPIA, WA 98501
Provider Phone Number
(360) 943-0910
Provider SSA County
330
Provider County Name
Thurston
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
28
Number of Residents in Certified Beds
26
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BD OLYMPIA I, LLC
Date First Approved to Provide Medicare and Medicaid services
2005-06-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
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
2.01923
Reported LPN Staffing Hours per Resident per Day
0.21923
Reported RN Staffing Hours per Resident per Day
1.07115
Reported Licensed Staffing Hours per Resident per Day
1.29038
Reported Total Nurse Staffing Hours per Resident per Day
3.30961
Reported Physical Therapist Staffing Hours per Resident Per Day
0.35769
Expected CNA Staffing Hours per Resident per Day
2.19888
Expected LPN Staffing Hours per Resident per Day
0.60098
Expected RN Staffing Hours per Resident per Day
1.10796
Expected Total Nurse Staffing Hours per Resident per Day
3.90781
Adjusted CNA Staffing Hours per Resident per Day
2.25323
Adjusted LPN Staffing Hours per Resident per Day
0.30278
Adjusted RN Staffing Hours per Resident per Day
0.72238
Adjusted Total Nurse Staffing Hours per Resident per Day
3.41385
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2015-01-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
80
Cycle 2 Total Number of Health Deficiencies
27
Cycle 2 Number of Standard Health Deficiencies
16
Cycle 2 Number of Complaint Health Deficiencies
11
Cycle 2 Health Deficiency Score
267
Cycle 2 Standard Health Survey Date
2014-04-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
267
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2013-06-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
134.33300
Number of Facility Reported Incidents
4
Number of Substantiated Complaints
7
Number of Fines
3
Total Amount of Fines in Dollars
3770
Number of Payment Denials
0
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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