Providence Marianwood - Issaquah Nursing Home

General Information

UPDATE
Federal Provider Number
505418
Provider Name
PROVIDENCE MARIANWOOD
Provider Address
3725 PROVIDENCE POINT DRIVE SOUTHEAST
ISSAQUAH, WA 98029
Provider Phone Number
4253912800
Provider SSA County
160
Provider County Name
King
Ownership Type
Non profit - Church related
Number of Certified Beds
117
Number of Residents in Certified Beds
81
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Date First Approved to Provide Medicare and Medicaid services
1992-01-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
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
2.96481
Reported LPN Staffing Hours per Resident per Day
0.14444
Reported RN Staffing Hours per Resident per Day
1.64938
Reported Licensed Staffing Hours per Resident per Day
1.79383
Reported Total Nurse Staffing Hours per Resident per Day
4.75863
Reported Physical Therapist Staffing Hours per Resident Per Day
0.40123
Expected CNA Staffing Hours per Resident per Day
2.49878
Expected LPN Staffing Hours per Resident per Day
0.70410
Expected RN Staffing Hours per Resident per Day
1.29252
Expected Total Nurse Staffing Hours per Resident per Day
4.49539
Adjusted CNA Staffing Hours per Resident per Day
2.91132
Adjusted LPN Staffing Hours per Resident per Day
0.17027
Adjusted RN Staffing Hours per Resident per Day
0.95350
Adjusted Total Nurse Staffing Hours per Resident per Day
4.26694
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
16
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
96
Cycle 1 Standard Survey Health Date
2014-05-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
96
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
88
Cycle 2 Standard Health Survey Date
2013-03-20
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
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-03-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
85.33300
Number of Facility Reported Incidents
2
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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