Life Care Center of Port Orchard
2031 Pottery Avenue, Port Orchard, WA 98366


Life Care Center of Port Orchard is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 505210. The address is 2031 Pottery Avenue, Port Orchard, WA 98366. The zip code is 98366. The phone number is 3608768035.


Life Care Center of Port Orchard · 2031 Pottery Avenue, Port Orchard, WA 98366

Federal Provider Number 505210
Provider Name LIFE CARE CENTER OF PORT ORCHARD
Address 2031 POTTERY AVENUE
PORT ORCHARD, WA 98366
Phone Number 3608768035
SSA County Code 170
County Name Kitsap
Ownership Type For profit - Corporation
Certified Beds 125
Certified Beds Residents 107
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name PORT ORCHARD OPERATIONS, LLC
Date First Approved to Provide Medicare Medicaid Services 08/01/1979
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 3
Health Inspection Rating 2
Quality Measure Rating 3
Staffing Rating 4
RN Staffing Rating 4
Reported CNA Staffing Hours per Resident per Day 2.20841
Reported LPN Staffing Hours per Resident per Day 0.73692
Reported RN Staffing Hours per Resident per Day 0.85888
Reported Licensed Staffing Hours per Resident per Day 1.59579
Reported Total Nurse Staffing Hours per Resident per Day 3.80421
Reported Physical Therapist Staffing Hours per Resident Per Day 0.13551
Expected CNA Staffing Hours per Resident per Day 2.40389
Expected LPN Staffing Hours per Resident per Day 0.63778
Expected RN Staffing Hours per Resident per Day 1.04497
Expected Total Nurse Staffing Hours per Resident per Day 4.08663
Adjusted CNA Staffing Hours per Resident per Day 2.25417
Adjusted LPN Staffing Hours per Resident per Day 0.95903
Adjusted RN Staffing Hours per Resident per Day 0.61414
Adjusted Total Nurse Staffing Hours per Resident per Day 3.75233
Cycle 1 Total Number of Health Deficiencies 17
Cycle 1 Number of Standard Health Deficiencies 14
Cycle 1 Number of Complaint Health Deficiencies 3
Cycle 1 Health Deficiency Score 152
Cycle 1 Standard Survey Health Date 10/12/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 152
Cycle 2 Total Number of Health Deficiencies 12
Cycle 2 Number of Standard Health Deficiencies 1
Cycle 2 Number of Complaint Health Deficiencies 11
Cycle 2 Health Deficiency Score 112
Cycle 2 Standard Health Survey Date 11/16/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 112
Cycle 3 Total Number of Health Deficiencies 5
Cycle 3 Number of Standard Health Deficiencies 3
Cycle 3 Number of Complaint Health Deficiencies 2
Cycle 3 Health Deficiency Score 20
Cycle 3 Standard Health Survey Date 09/17/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 20
Total Weighted Health Survey Score 116.667
Number of Facility Reported Incidents 5
Number of Substantiated Complaints 9
Number of Fines 2
Total Amount of Fines in Dollars $5233.00
Total Number of Penalties 2
Processing Date 08/01/2017

Owner or Manager · Life Care Center of Port Orchard

Owner Name Role Association Date
CROSS, CINDY (Individual) OFFICER since 09/19/2008
FLETCHER, TODD (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
25%
since 09/19/2008
LIFE CARE CENTERS OF AMERICA, INC. (Organization) OPERATIONAL/MANAGERIAL CONTROL since 10/30/2008
MUELLER, BROOKE (Individual) MANAGING EMPLOYEE since 10/01/2014
PRESTON, FORREST (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
74%
since 09/19/2008
PRESTON, FORREST (Individual) OFFICER since 09/19/2008
THURMOND, JOAN (Individual) OFFICER since 09/19/2008

street_number: 2031
route: Pottery Avenue (Pottery Ave)
locality, political: Port Orchard
admin_level_2, political: Kitsap County
admin_level_1, political: Washington (WA)
country, political: United States (US)
postal_code: 98366
postal_code_suffix: 2010
types : premise
latitude: 47.5168623
longitude: -122.6514004
latlng: (47.5168623, -122.6514004)


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