Providence Mother Joseph Care
3333 Ensign Road Northeast, Olympia, WA 98506


Providence Mother Joseph Care is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 505387. The address is 3333 Ensign Road Northeast, Olympia, WA 98506. The zip code is 98506. The phone number is 3604934900.


Providence Mother Joseph Care · 3333 Ensign Road Northeast, Olympia, WA 98506

Federal Provider Number 505387
Provider Name PROVIDENCE MOTHER JOSEPH CARE
Address 3333 ENSIGN ROAD NORTHEAST
OLYMPIA, WA 98506
Phone Number 3604934900
SSA County Code 330
County Name Thurston
Ownership Type Non profit - Corporation
Certified Beds 152
Certified Beds Residents 135
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name PROVIDENCE HEALTH & SERVICES WASHINGTON
Date First Approved to Provide Medicare Medicaid Services 06/07/1991
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 5
Health Inspection Rating 3
Quality Measure Rating 5
Staffing Rating 4
RN Staffing Rating 4
Reported CNA Staffing Hours per Resident per Day 2.55259
Reported LPN Staffing Hours per Resident per Day 0.89963
Reported RN Staffing Hours per Resident per Day 0.97185
Reported Licensed Staffing Hours per Resident per Day 1.87148
Reported Total Nurse Staffing Hours per Resident per Day 4.42407
Reported Physical Therapist Staffing Hours per Resident Per Day 0.24815
Expected CNA Staffing Hours per Resident per Day 2.48573
Expected LPN Staffing Hours per Resident per Day 0.67734
Expected RN Staffing Hours per Resident per Day 1.20837
Expected Total Nurse Staffing Hours per Resident per Day 4.37144
Adjusted CNA Staffing Hours per Resident per Day 2.5197
Adjusted LPN Staffing Hours per Resident per Day 1.10239
Adjusted RN Staffing Hours per Resident per Day 0.60095
Adjusted Total Nurse Staffing Hours per Resident per Day 4.07943
Cycle 1 Total Number of Health Deficiencies 10
Cycle 1 Number of Standard Health Deficiencies 4
Cycle 1 Number of Complaint Health Deficiencies 6
Cycle 1 Health Deficiency Score 88
Cycle 1 Standard Survey Health Date 12/02/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 88
Cycle 2 Total Number of Health Deficiencies 14
Cycle 2 Number of Standard Health Deficiencies 11
Cycle 2 Number of Complaint Health Deficiencies 4
Cycle 2 Health Deficiency Score 100
Cycle 2 Standard Health Survey Date 11/10/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 100
Cycle 3 Total Number of Health Deficiencies 5
Cycle 3 Number of Standard Health Deficiencies 2
Cycle 3 Number of Complaint Health Deficiencies 3
Cycle 3 Health Deficiency Score 20
Cycle 3 Standard Health Survey Date 09/25/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 20
Total Weighted Health Survey Score 80.667
Number of Facility Reported Incidents 6
Number of Substantiated Complaints 7
Number of Fines 1
Total Amount of Fines in Dollars $2641.00
Total Number of Penalties 1
Processing Date 08/01/2017

Owner or Manager · Providence Mother Joseph Care

Owner Name Role Association Date
ALLEN, DICK (Individual) DIRECTOR since 07/01/2016
ANDERSON, DONALD (Individual) OFFICER since 01/01/2017
BLAIR, RICHARD (Individual) DIRECTOR since 07/01/2016
BUTLER, MICHAEL (Individual) OFFICER since 06/09/2016
CRAWFORD, ISIAAH (Individual) DIRECTOR since 02/01/2012
DEAN, LUCILLE (Individual) DIRECTOR since 07/01/2016
ESCASA-HAIGH, JO ANN (Individual) OFFICER since 01/01/2017
GORMALLY, KATE (Individual) MANAGING EMPLOYEE since 01/26/2004
HARVEY, SUSAN (Individual) MANAGING EMPLOYEE since 10/15/2007
HEJNA, DIANE (Individual) DIRECTOR since 07/01/2016
HELLRIGEL, ROBERT (Individual) MANAGING EMPLOYEE since 01/01/2009
HOLCOMB, MICHAEL (Individual) DIRECTOR since 01/01/2010
HUGHES, PHYLLIS (Individual) DIRECTOR since 01/01/2014
KOPFENSTEINER, THOMAS (Individual) DIRECTOR since 07/01/2016
LINER, SALLYE (Individual) DIRECTOR since 06/01/2010
LYONS, MARY (Individual) DIRECTOR since 07/01/2016
MIELE, CHRISTINA (Individual) MANAGING EMPLOYEE since 06/01/2015
NOCE, WALTER (Individual) DIRECTOR since 07/01/2016
OLSEN, DAVID (Individual) DIRECTOR since 02/01/2012
PROVIDENCE HEALTH & SERVICES-WASHINGTON (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 07/01/2016
PROVIDENCE HEALTH & SERVICES-WASHINGTON (Organization) OPERATIONAL/MANAGERIAL CONTROL since 01/06/2009
REYES, CAROLYN (Individual) DIRECTOR since 01/01/2014
STRAUSS, CYNTHIA (Individual) OFFICER since 06/11/2013
YANG, PHOEBE (Individual) DIRECTOR since 07/01/2016

street_number: 3333
route: Ensign Road Northeast (Ensign Rd NE)
locality, political: Olympia
admin_level_2, political: Thurston County
admin_level_1, political: Washington (WA)
country, political: United States (US)
postal_code: 98506
postal_code_suffix: 5012
types : premise
latitude: 47.0501345
longitude: -122.8495359
latlng: (47.0501345, -122.8495359)


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