Fircrest Convalescent Hospital
7025 Corline Court, Sebastopol, CA 95472


Fircrest Convalescent Hospital is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 055476. The address is 7025 Corline Court, Sebastopol, CA 95472. The zip code is 95472. The phone number is 7078237444.


Fircrest Convalescent Hospital · 7025 Corline Court, Sebastopol, CA 95472

Federal Provider Number 055476
Provider Name FIRCREST CONVALESCENT HOSPITAL
Address 7025 CORLINE COURT
SEBASTOPOL, CA 95472
Phone Number 7078237444
SSA County Code 590
County Name Sonoma
Ownership Type For profit - Corporation
Certified Beds 50
Certified Beds Residents 39
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name SANDHYA INC.
Date First Approved to Provide Medicare Medicaid Services 11/01/1968
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating Footnote Rating Not Displayed
Health Inspection Rating 1
Quality Measure Rating 5
Staffing Rating Footnote Rating Not Displayed
RN Staffing Rating Footnote Rating Not Displayed
Reported CNA Staffing Hours per Resident per Day 3.02179
Reported LPN Staffing Hours per Resident per Day 0.51667
Reported RN Staffing Hours per Resident per Day 0.9641
Reported Licensed Staffing Hours per Resident per Day 1.48077
Reported Total Nurse Staffing Hours per Resident per Day 4.50256
Reported Physical Therapist Staffing Hours per Resident Per Day 0.10128
Expected CNA Staffing Hours per Resident per Day 2.42192
Expected LPN Staffing Hours per Resident per Day 0.57971
Expected RN Staffing Hours per Resident per Day 0.79692
Expected Total Nurse Staffing Hours per Resident per Day 3.79855
Adjusted CNA Staffing Hours per Resident per Day 3.06144
Adjusted LPN Staffing Hours per Resident per Day 0.73974
Adjusted RN Staffing Hours per Resident per Day 0.90395
Adjusted Total Nurse Staffing Hours per Resident per Day 4.77798
Cycle 1 Total Number of Health Deficiencies 22
Cycle 1 Number of Standard Health Deficiencies 21
Cycle 1 Number of Complaint Health Deficiencies 3
Cycle 1 Health Deficiency Score 236
Cycle 1 Standard Survey Health Date 07/26/2016
Cycle 1 Number of Health Revisits 3
Cycle 1 Health Revisit Score 165
Cycle 1 Total Health Score 401
Cycle 2 Total Number of Health Deficiencies 18
Cycle 2 Number of Standard Health Deficiencies 9
Cycle 2 Number of Complaint Health Deficiencies 10
Cycle 2 Health Deficiency Score 176
Cycle 2 Standard Health Survey Date 07/24/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 176
Cycle 3 Total Number of Health Deficiencies 9
Cycle 3 Number of Standard Health Deficiencies 9
Cycle 3 Health Deficiency Score 84
Cycle 3 Standard Health Survey Date 07/11/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 84
Total Weighted Health Survey Score 273.167
Number of Facility Reported Incidents 11
Number of Substantiated Complaints 5
Number of Fines 1
Total Amount of Fines in Dollars $122287.00
Number of Payment Denials 1
Total Number of Penalties 2
Processing Date 08/01/2017

Owner or Manager · Fircrest Convalescent Hospital

Owner Name Role Association Date
BESSMER, CHRISTINE (Individual) MANAGING EMPLOYEE since 12/01/2015
BESSMER, CHRISTINE (Individual) OPERATIONAL/MANAGERIAL CONTROL since 12/01/2015
CAMP, RICHARD (Individual) MANAGING EMPLOYEE since 09/19/2016
CAMP, RICHARD (Individual) OPERATIONAL/MANAGERIAL CONTROL since 09/19/2016
THEKKEK, ANTONY (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
50%
since 09/01/2011
THEKKEK, PREMA (Individual) OFFICER since 11/15/2001
TRASK, APRIL (Individual) MANAGING EMPLOYEE since 01/01/2016

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