Willow Wood Care Center - Salt Lake City Nursing Home
General Information
UPDATEFederal Provider Number
465074
Provider Name
WILLOW WOOD CARE CENTER
Provider Address
1205 EAST 4725 SOUTH
SALT LAKE CITY, UT 84117
SALT LAKE CITY, UT 84117
Provider Phone Number
(801) 262-2908
Provider SSA County
170
Provider County Name
Salt Lake
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
77
Number of Residents in Certified Beds
59
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WILLOW WOOD CARE CENTER INC
Date First Approved to Provide Medicare and Medicaid services
1980-05-16
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
3
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
2.39237
Reported LPN Staffing Hours per Resident per Day
0.31610
Reported RN Staffing Hours per Resident per Day
1.17373
Reported Licensed Staffing Hours per Resident per Day
1.48983
Reported Total Nurse Staffing Hours per Resident per Day
3.88220
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04831
Expected CNA Staffing Hours per Resident per Day
2.90219
Expected LPN Staffing Hours per Resident per Day
0.71198
Expected RN Staffing Hours per Resident per Day
1.12318
Expected Total Nurse Staffing Hours per Resident per Day
4.73735
Adjusted CNA Staffing Hours per Resident per Day
2.02266
Adjusted LPN Staffing Hours per Resident per Day
0.36850
Adjusted RN Staffing Hours per Resident per Day
0.78083
Adjusted Total Nurse Staffing Hours per Resident per Day
3.30327
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2015-01-21
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-12-18
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2013-01-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
28.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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