General Information: HAVEN OF FLAGSTAFF, LLC
Nursing home name HAVEN OF FLAGSTAFF, LLC
Address800 WEST UNIVERSITY AVENUE
FLAGSTAFF, AZ 86001
Phone number (928) 779-6931
Located within a hospital No
Type of ownership For profit - Corporation
Owner operates multiple homesYes
Accept Medicare or Medicaid Medicare and Medicaid
Continue Care Retirement CommunityNo
Resident and family councils Resident
Certified number of beds 80
Total number of residents 74
Perc of occupied beds 92
Sprinkler status Yes
Number of Facility Reported Incidents0
Number of Substantiated Complaints0
Number of Fines0
Total Amount of Fines$0
Total Number of Penalties0
Total Number of Penalties0
Ratings Summary: HAVEN OF FLAGSTAFF, LLC
Overall rating 4
4
Nursing Home Staffing 3
3
Registered Nurses only 4
4
Health Inspections 4
4
Quality Measures 3
3
Nursing Home Staffing Info: HAVEN OF FLAGSTAFF, LLC
National AverageArizona AverageHAVEN OF FLAGSTAFF, LLC
Overall staff rating NA NA 3
3
Registered Nurses only rating NANA 4
4
Total Number of Residents NA NA 74
Total Number of Nurse Staff Hours per Resident per Day 4.11 hours 4.56 hours 3.43 hours
Total Number of Licensed Nurse Staff Hours per Resident per Day 1.64 hours 1.94 hours 1.16 hours
Registered Nurses Hours per Residents per Day 0.81 hours 1.03 hours 0.81 hours
Licensed Practical or Vacation Nurses Hours per Resident per Day 0.83 hours 0.91 hours 0.36 hours
Certified Nursing Assistants Hours per Residents per Day 2.47 hours 2.62 hours 2.26 hours
Physical Therapy Staffing Hours per Resident Per Day 0.1 hours 0.16 hours 0.12 hours
Health Survey: HAVEN OF FLAGSTAFF, LLC
Heath Survey Summary on 2013-03-07
Total Number of Health Deficiencies 7
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Heath Survey Summary on 2011-12-08
Total Number of Health Deficiencies 3
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Heath Survey Summary on 2010-10-08
Total Number of Health Deficiencies 8
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Health Survey Details: HAVEN OF FLAGSTAFF, LLC
Inspection Results: 03/07/2013
Corrected Deficiency Scope and Severity
04/05/2013 Give residents a notice of rights, rules, services and charges. Pattern/Potential for minimal harm
04/05/2013 Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Isolated/Minimal harm or potential for actual harm
04/05/2013 Allow residents the right to participate in the planning or revision of care and treatment. Isolated/Minimal harm or potential for actual harm
04/05/2013 Store, cook, and serve food in a safe and clean way. Pattern/Minimal harm or potential for actual harm
04/05/2013 Provide routine and 24-hour emergency dental care for each resident. Pattern/Minimal harm or potential for actual harm
04/05/2013 Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. Pattern/Minimal harm or potential for actual harm
04/05/2013 Have a program that investigates, controls and keeps infection from spreading. Isolated/Minimal harm or potential for actual harm
Inspection Results: 12/08/2011
Corrected Deficiency Scope and Severity
01/11/2012 Have a program that investigates, controls and keeps infection from spreading. Pattern/Minimal harm or potential for actual harm
01/11/2012 Provide necessary care and services to maintain or improve the highest well being of each resident . Isolated/Minimal harm or potential for actual harm
01/11/2012 Store, cook, and serve food in a safe and clean way. Pattern/Minimal harm or potential for actual harm
Inspection Results: 10/08/2010
Corrected Deficiency Scope and Severity
11/15/2010 Give notice to the resident before a room or roommate change. Isolated/Minimal harm or potential for actual harm
11/15/2010 Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Isolated/Minimal harm or potential for actual harm
11/15/2010 Give residents a notice of rights, rules, services and charges. Isolated/Minimal harm or potential for actual harm
11/15/2010 Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Isolated/Minimal harm or potential for actual harm
11/15/2010 Provide necessary care and services to maintain or improve the highest well being of each resident . Isolated/Minimal harm or potential for actual harm
11/15/2010 Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. Isolated/Minimal harm or potential for actual harm
11/15/2010 Store, cook, and serve food in a safe and clean way. Pattern/Minimal harm or potential for actual harm
11/15/2010 Keep accurate, complete and organized clinical records on each resident that meet professional standards. Isolated/Minimal harm or potential for actual harm

Fire Safety Survey: HAVEN OF FLAGSTAFF, LLC
Fire Safety Survey Summary on 2013-03-12
Total Number of Fire SafetyDeficiencies 3
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2011-12-22
Total Number of Fire SafetyDeficiencies 5
Scope and Severity of most Severe Health Deficiency Isolated/Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2010-10-14
Total Number of Fire SafetyDeficiencies 0
Scope and Severity of most Severe Health Deficiency
Fire Safety Survey: HAVEN OF FLAGSTAFF, LLC
Fire Safety Survey Results: 03/12/2013
Corrected Deficiency Severity
04/01/2013 Special areas constructed so that walls can resist fire for one hour or an approved fire extinguishing system. Isolated/Minimal harm or potential for actual harm
04/01/2013 Properly maintained smoke detectors. Isolated/Minimal harm or potential for actual harm
04/01/2013 Properly installed electrical wiring and equipment. Pattern/Minimal harm or potential for actual harm
Fire Safety Survey Results: 12/22/2011
Corrected Deficiency Severity
01/11/2012 Special areas constructed so that walls can resist fire for one hour or an approved fire extinguishing system. Isolated/Minimal harm or potential for actual harm
01/11/2012 Corridor and hallway doors that block smoke. Isolated/Minimal harm or potential for actual harm
01/11/2012 Exits that are accessible at all times. Isolated/Minimal harm or potential for actual harm
01/11/2012 Automatic sprinkler systems that have been maintained in working order. Isolated/Minimal harm or potential for actual harm
01/11/2012 Properly installed electrical wiring and equipment. Isolated/Minimal harm or potential for actual harm

Resident Complaints: HAVEN OF FLAGSTAFF, LLC
Not available

Quality Measures: HAVEN OF FLAGSTAFF, LLC
Quality Measures National Average Arizona Average HAVEN OF FLAGSTAFF, LLC
Overall quality rating NA NA 3
3
Long-Stay Residents
Percent of Long Stay Residents Whose Need for Help with ADLs has Increased 15.4% 15.3% 10.5%
Percent of Long Stay Residents Who Self Report Moderate to Severe Pain 8.3% 10.7% 20.4%
Percent of High Risk Long Stay Residents With Pressure Ulcers 6.1% 6.1% 6.9%
Percent of Long Stay Residents Who Lose Too Much Weight 7.2% 6.7% 11.7%
Percent of Low Risk Long Stay Residents Who Lose Control of Their Bowel or Bladder 43.9% 51.5% 71.0%
Percent of Long Stay Residents with a Catheter Inserted and Left in Their Bladder 3.2% 4.5% 2.7%
Percent of Long Stay Residents With a Urinary Tract Infection 6.2% 6.2% 8.5%
Percent of Long Stay Residents Who Have Depressive Symptoms 6.3% 4.0% 2.4%
Percent of Long Stay Residents Who Were Physically Restrained 1.4% 0.7% 1.1%
Percent of Long Stay Residents Experiencing One or More Falls with Major Injury 3.2% 2.7% 6.8%
Percent of Long Stay Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine 92.7% 95.0% 100.0%
Percent of Long Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 94.3% 95.9% 100.0%
Percent of Long Stay Residents Who Received an Antipsychotic Medication 20.7% 20.3% 4.8%
Short-Stay Residents
Percent of Short Stay Residents Who Self Report Moderate to Severe Pain 19.2% 23.7% 15.2%
Percent of Short Stay Residents With Pressure Ulcers That Are New or Worsened 1.2% 0.7% 1.0%
Percent of Short Stay Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine 83.4% 89.9% 75.3%
Percent of Short Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 82.4% 88.9% 89.7%
Percent of Short Stay Residents Who Newly Received an Antipsychotic Medication 2.6% 2.0% 0.0%

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