Petaluma Post-acute Rehabilitation - Petaluma Nursing Home
General Information
UPDATEFederal Provider Number
56072
Provider Name
PETALUMA POST-ACUTE REHABILITATION
Provider Address
1115 B STREET
PETALUMA, CA 94952
PETALUMA, CA 94952
Provider Phone Number
(707) 765-3030
Provider SSA County
590
Provider County Name
Sonoma
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
90
Number of Residents in Certified Beds
77
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PETALUMA C.C. INC.
Date First Approved to Provide Medicare and Medicaid services
1969-05-22
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
5
Overall Rating Footnote
Health Inspection Rating
4
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
2.50649
Reported LPN Staffing Hours per Resident per Day
0.57857
Reported RN Staffing Hours per Resident per Day
1.44156
Reported Licensed Staffing Hours per Resident per Day
2.02013
Reported Total Nurse Staffing Hours per Resident per Day
4.52662
Reported Physical Therapist Staffing Hours per Resident Per Day
0.21883
Expected CNA Staffing Hours per Resident per Day
2.42124
Expected LPN Staffing Hours per Resident per Day
0.68502
Expected RN Staffing Hours per Resident per Day
1.38071
Expected Total Nurse Staffing Hours per Resident per Day
4.48697
Adjusted CNA Staffing Hours per Resident per Day
2.54009
Adjusted LPN Staffing Hours per Resident per Day
0.70102
Adjusted RN Staffing Hours per Resident per Day
0.78013
Adjusted Total Nurse Staffing Hours per Resident per Day
4.06652
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-12-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-12-23
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-12-13
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
38.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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