Broadway Villa Post Acute
1250 Broadway, Sonoma, CA 95476


Broadway Villa Post Acute is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 055987. The address is 1250 Broadway, Sonoma, CA 95476. The zip code is 95476. The phone number is 7079388406.


Broadway Villa Post Acute · 1250 Broadway, Sonoma, CA 95476

Federal Provider Number 055987
Provider Name BROADWAY VILLA POST ACUTE
Address 1250 BROADWAY
SONOMA, CA 95476
Phone Number 7079388406
SSA County Code 590
County Name Sonoma
Ownership Type For profit - Corporation
Certified Beds 144
Certified Beds Residents 123
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name ENSIGN SONOMA LLC
Date First Approved to Provide Medicare Medicaid Services 07/01/1974
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 4
Health Inspection Rating 2
Quality Measure Rating 5
Staffing Rating 4
RN Staffing Rating 4
Reported CNA Staffing Hours per Resident per Day 2.73171
Reported LPN Staffing Hours per Resident per Day 0.78902
Reported RN Staffing Hours per Resident per Day 0.6935
Reported Licensed Staffing Hours per Resident per Day 1.48252
Reported Total Nurse Staffing Hours per Resident per Day 4.21423
Reported Physical Therapist Staffing Hours per Resident Per Day 0.08089
Expected CNA Staffing Hours per Resident per Day 2.45793
Expected LPN Staffing Hours per Resident per Day 0.60091
Expected RN Staffing Hours per Resident per Day 0.92371
Expected Total Nurse Staffing Hours per Resident per Day 3.98255
Adjusted CNA Staffing Hours per Resident per Day 2.72701
Adjusted LPN Staffing Hours per Resident per Day 1.08982
Adjusted RN Staffing Hours per Resident per Day 0.56098
Adjusted Total Nurse Staffing Hours per Resident per Day 4.26539
Cycle 1 Total Number of Health Deficiencies 12
Cycle 1 Number of Standard Health Deficiencies 9
Cycle 1 Number of Complaint Health Deficiencies 3
Cycle 1 Health Deficiency Score 96
Cycle 1 Standard Survey Health Date 05/23/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 96
Cycle 2 Total Number of Health Deficiencies 6
Cycle 2 Number of Standard Health Deficiencies 6
Cycle 2 Health Deficiency Score 36
Cycle 2 Standard Health Survey Date 06/12/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 36
Cycle 3 Total Number of Health Deficiencies 8
Cycle 3 Number of Standard Health Deficiencies 7
Cycle 3 Number of Complaint Health Deficiencies 1
Cycle 3 Health Deficiency Score 84
Cycle 3 Standard Health Survey Date 06/18/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 84
Total Weighted Health Survey Score 74
Number of Facility Reported Incidents 5
Number of Substantiated Complaints 5
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Broadway Villa Post Acute

Owner Name Role Association Date
BURNAM, SOON (Individual) OFFICER since 01/30/2006
CHRISTENSEN, CHRISTOPHER (Individual) DIRECTOR since 01/30/2006
ENSIGN GROUP, INC. (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
100%
since 01/30/2006
NORTHERN PIONEER HEALTHCARE INC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 01/30/2006
RUTTER, MATTHEW (Individual) MANAGING EMPLOYEE since 10/22/2012
RUTTER, MATTHEW (Individual) OFFICER since 08/12/2012
RUTTER, MATTHEW (Individual) OPERATIONAL/MANAGERIAL CONTROL since 10/22/2012
SNAPPER, SUZANNE (Individual) OFFICER since 01/14/2012
STAPLEY, GREGORY (Individual) OFFICER since 10/29/1999
WITTEKIND, BEVERLY (Individual) OFFICER since 01/30/2006

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