Stafford Healthcare - Des Moines Nursing Home

General Information

UPDATE
Federal Provider Number
505513
Provider Name
STAFFORD HEALTHCARE
Provider Address
2800 SOUTH 224TH STREET,
DES MOINES, WA 98198
Provider Phone Number
2068240600
Provider SSA County
160
Provider County Name
King
Ownership Type
For profit - Partnership
Number of Certified Beds
165
Number of Residents in Certified Beds
92
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
STAFFORD HEALTHCARE, SEATAC, LLC
Date First Approved to Provide Medicare and Medicaid services
2004-02-02
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
3
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
3.08315
Reported LPN Staffing Hours per Resident per Day
0.91630
Reported RN Staffing Hours per Resident per Day
1.76630
Reported Licensed Staffing Hours per Resident per Day
2.68261
Reported Total Nurse Staffing Hours per Resident per Day
5.76575
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12826
Expected CNA Staffing Hours per Resident per Day
2.71150
Expected LPN Staffing Hours per Resident per Day
0.75106
Expected RN Staffing Hours per Resident per Day
1.31559
Expected Total Nurse Staffing Hours per Resident per Day
4.77815
Adjusted CNA Staffing Hours per Resident per Day
2.79001
Adjusted LPN Staffing Hours per Resident per Day
1.01261
Adjusted RN Staffing Hours per Resident per Day
1.00319
Adjusted Total Nurse Staffing Hours per Resident per Day
4.86405
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-04-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2012-12-20
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
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-01-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
44.00000
Number of Facility Reported Incidents
1
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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