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Park Shore - Seattle Nursing Home

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Federal Provider Number
505493
Provider Name
PARK SHORE
Provider Address
1630 43RD AVENUE EAST
SEATTLE, WA 98112
Provider Phone Number
(206) 329-0770
Provider SSA County
160
Provider County Name
King
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
28
Number of Residents in Certified Beds
25
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST
Date First Approved to Provide Medicare and Medicaid services
1995-08-10
Continuing Care Retirement Community
Y
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
5
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
3.01800
Reported LPN Staffing Hours per Resident per Day
0.70000
Reported RN Staffing Hours per Resident per Day
1.37400
Reported Licensed Staffing Hours per Resident per Day
2.07400
Reported Total Nurse Staffing Hours per Resident per Day
5.09200
Reported Physical Therapist Staffing Hours per Resident Per Day
0.22800
Expected CNA Staffing Hours per Resident per Day
2.48190
Expected LPN Staffing Hours per Resident per Day
0.63792
Expected RN Staffing Hours per Resident per Day
0.95582
Expected Total Nurse Staffing Hours per Resident per Day
4.07563
Adjusted CNA Staffing Hours per Resident per Day
2.98371
Adjusted LPN Staffing Hours per Resident per Day
0.91077
Adjusted RN Staffing Hours per Resident per Day
1.07411
Adjusted Total Nurse Staffing Hours per Resident per Day
5.03611
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-10-03
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
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-10-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-07-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
28.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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