Park Manor Rehabilitation Ctr - Walla Walla Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
505074
Provider Name
PARK MANOR REHABILITATION CTR
Provider Address
1710 PLAZA WAY
WALLA WALLA, WA 99362
WALLA WALLA, WA 99362
Provider Phone Number
(509) 529-4218
Provider SSA County
350
Provider County Name
Walla Walla
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
81
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MANOR PARK HEALTHCARE LLC
Date First Approved to Provide Medicare and Medicaid services
1972-11-01
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
3
Health Inspection Rating Footnote
QM Rating
4
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
2.87222
Reported LPN Staffing Hours per Resident per Day
0.23889
Reported RN Staffing Hours per Resident per Day
1.86111
Reported Licensed Staffing Hours per Resident per Day
2.10000
Reported Total Nurse Staffing Hours per Resident per Day
4.97222
Reported Physical Therapist Staffing Hours per Resident Per Day
0.22840
Expected CNA Staffing Hours per Resident per Day
2.65104
Expected LPN Staffing Hours per Resident per Day
0.63508
Expected RN Staffing Hours per Resident per Day
0.98320
Expected Total Nurse Staffing Hours per Resident per Day
4.26932
Adjusted CNA Staffing Hours per Resident per Day
2.65842
Adjusted LPN Staffing Hours per Resident per Day
0.31221
Adjusted RN Staffing Hours per Resident per Day
1.41438
Adjusted Total Nurse Staffing Hours per Resident per Day
4.69455
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-05-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
84
Cycle 2 Standard Health Survey Date
2013-03-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
84
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-02-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
43.33300
Number of Facility Reported Incidents
4
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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