Grays Harbor Health & Rehabilitation Center
920 Anderson Drive, Aberdeen, WA 98520


Grays Harbor Health & Rehabilitation Center is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 505016. The address is 920 Anderson Drive, Aberdeen, WA 98520. The zip code is 98520. The phone number is 3605325122.


Grays Harbor Health & Rehabilitation Center · 920 Anderson Drive, Aberdeen, WA 98520

Federal Provider Number 505016
Provider Name GRAYS HARBOR HEALTH & REHABILITATION CENTER
Address 920 ANDERSON DRIVE
ABERDEEN, WA 98520
Phone Number 3605325122
SSA County Code 130
County Name Grays Harbor
Ownership Type For profit - Corporation
Certified Beds 105
Certified Beds Residents 59
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name AVALON CARE CENTER - ABERDEEN, LLC
Date First Approved to Provide Medicare Medicaid Services 01/01/1967
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 2
Health Inspection Rating 1
Quality Measure Rating 4
Staffing Rating 4
RN Staffing Rating 5
Reported CNA Staffing Hours per Resident per Day 2.5339
Reported LPN Staffing Hours per Resident per Day 0.52288
Reported RN Staffing Hours per Resident per Day 1.05508
Reported Licensed Staffing Hours per Resident per Day 1.57797
Reported Total Nurse Staffing Hours per Resident per Day 4.11186
Reported Physical Therapist Staffing Hours per Resident Per Day 0.07627
Expected CNA Staffing Hours per Resident per Day 2.44532
Expected LPN Staffing Hours per Resident per Day 0.59158
Expected RN Staffing Hours per Resident per Day 0.92201
Expected Total Nurse Staffing Hours per Resident per Day 3.95891
Adjusted CNA Staffing Hours per Resident per Day 2.54259
Adjusted LPN Staffing Hours per Resident per Day 0.73361
Adjusted RN Staffing Hours per Resident per Day 0.85504
Adjusted Total Nurse Staffing Hours per Resident per Day 4.18663
Cycle 1 Total Number of Health Deficiencies 16
Cycle 1 Number of Standard Health Deficiencies 13
Cycle 1 Number of Complaint Health Deficiencies 4
Cycle 1 Health Deficiency Score 156
Cycle 1 Standard Survey Health Date 08/17/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 156
Cycle 2 Total Number of Health Deficiencies 23
Cycle 2 Number of Standard Health Deficiencies 18
Cycle 2 Number of Complaint Health Deficiencies 5
Cycle 2 Health Deficiency Score 160
Cycle 2 Standard Health Survey Date 09/17/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 160
Cycle 3 Total Number of Health Deficiencies 12
Cycle 3 Number of Standard Health Deficiencies 11
Cycle 3 Number of Complaint Health Deficiencies 1
Cycle 3 Health Deficiency Score 52
Cycle 3 Standard Health Survey Date 10/14/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 52
Total Weighted Health Survey Score 140
Number of Facility Reported Incidents 2
Number of Substantiated Complaints 7
Number of Fines 3
Total Amount of Fines in Dollars $71243.00
Total Number of Penalties 3
Processing Date 08/01/2017

Owner or Manager · Grays Harbor Health & Rehabilitation Center

Owner Name Role Association Date
AVALON CARE LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 08/26/2003
AVALON HEALTH CARE MANAGEMENT OF WASHINGTON LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 08/26/2003
AVALON HEALTH CARE MANAGEMENT, INC. (Organization) OPERATIONAL/MANAGERIAL CONTROL since 08/02/2003
AVALON HEALTH CARE, INC. (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 08/26/2003
AVALON HOLDING, INC. (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 08/26/2003
AVALON OF WASHINGTON LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 08/26/2003
BURTON, HAROLD (Individual) DIRECTOR since 08/26/2014
CARPENTER, SCOTT (Individual) OFFICER since 05/28/2013
DANGERFIELD, DAVID (Individual) DIRECTOR since 09/01/2007
DEANS, LAWRENCE (Individual) DIRECTOR since 10/15/2013
DEANS, LAWRENCE (Individual) OFFICER since 10/15/2013
FRANKLIN, CHRISTIE (Individual) OFFICER since 08/28/2012
GARRETT, LEWIS (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2003
GARRETT, LEWIS (Individual) DIRECTOR since 11/14/2003
GONZALES, CHARLES (Individual) DIRECTOR since 08/11/2009
HESS, RITA (Individual) OFFICER since 02/24/2014
KIRTON, CHARLES (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2003
KIRTON, CHARLES (Individual) DIRECTOR since 11/14/2003
KIRTON, CHARLES (Individual) OFFICER since 10/23/2012
KNAPTON, KENNETH (Individual) OFFICER since 08/01/2013
LINCOLN, FAYE (Individual) OFFICER since 12/01/2003
MASON, JAMES (Individual) DIRECTOR since 06/30/2004
SANDERS, MARK (Individual) MANAGING EMPLOYEE since 02/28/2013
STUART, ANNE (Individual) OFFICER since 03/01/2014
SWINTON, BRIAN (Individual) DIRECTOR since 06/04/2004
TIPPETS, CARL (Individual) DIRECTOR since 09/22/2006
WOLTIL, ROBERT (Individual) DIRECTOR since 05/23/2012

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