General Information: FIDALGO CARE CENTER
Nursing home name FIDALGO CARE CENTER
Address1105 27TH STREET
ANACORTES, WA 98221
Phone number (360) 293-3174
Located within a hospital No
Type of ownership For profit - Corporation
Owner operates multiple homesNo
Accept Medicare or Medicaid Medicare and Medicaid
Continue Care Retirement CommunityYes
Resident and family councils Resident
Certified number of beds 44
Total number of residents 37
Perc of occupied beds 84
Sprinkler status Yes
Number of Facility Reported Incidents2
Number of Substantiated Complaints3
Number of Fines0
Total Amount of Fines$0
Total Number of Penalties0
Total Number of Penalties0
Ratings Summary: FIDALGO CARE CENTER
Overall rating 4
4
Nursing Home Staffing 4
4
Registered Nurses only 4
4
Health Inspections 4
4
Quality Measures 2
2
Nursing Home Staffing Info: FIDALGO CARE CENTER
National AverageWashington AverageFIDALGO CARE CENTER
Overall staff rating NA NA 4
4
Registered Nurses only rating NANA 4
4
Total Number of Residents NA NA 37
Total Number of Nurse Staff Hours per Resident per Day 4.11 hours 4.42 hours 5.6 hours
Total Number of Licensed Nurse Staff Hours per Resident per Day 1.64 hours 1.76 hours 2.02 hours
Registered Nurses Hours per Residents per Day 0.81 hours 1.15 hours 1.11 hours
Licensed Practical or Vacation Nurses Hours per Resident per Day 0.83 hours 0.61 hours 0.92 hours
Certified Nursing Assistants Hours per Residents per Day 2.47 hours 2.65 hours 3.58 hours
Physical Therapy Staffing Hours per Resident Per Day 0.1 hours 0.15 hours 0.48 hours
Health Survey: FIDALGO CARE CENTER
Heath Survey Summary on 2013-09-06
Total Number of Health Deficiencies 1
Scope and Severity of most Severe Health Deficiency Isolated/Minimal harm or potential for actual harm
Heath Survey Summary on 2012-05-11
Total Number of Health Deficiencies 1
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Heath Survey Summary on 2011-06-24
Total Number of Health Deficiencies 3
Scope and Severity of most Severe Health Deficiency Isolated/Minimal harm or potential for actual harm
Health Survey Details: FIDALGO CARE CENTER
Inspection Results: 09/06/2013
Corrected Deficiency Scope and Severity
11/01/2013 Coordinate assessments with the pre-admission screening and resident review program for mentally-ill and mentally-retarded patients. Isolated/Minimal harm or potential for actual harm
Inspection Results: 05/11/2012
Corrected Deficiency Scope and Severity
06/01/2012 Store, cook, and serve food in a safe and clean way. Pattern/Minimal harm or potential for actual harm
Inspection Results: 06/24/2011
Corrected Deficiency Scope and Severity
07/27/2011 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
07/27/2011 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
07/27/2011 At least once a month, have a licensed pharmacist review each resident's medication(s) and report any irregularities to the attending doctor. Isolated/Minimal harm or potential for actual harm

Fire Safety Survey: FIDALGO CARE CENTER
Fire Safety Survey Summary on 2013-09-06
Total Number of Fire SafetyDeficiencies 7
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2012-05-15
Total Number of Fire SafetyDeficiencies 2
Scope and Severity of most Severe Health Deficiency Isolated/Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2011-06-20
Total Number of Fire SafetyDeficiencies 3
Scope and Severity of most Severe Health Deficiency Isolated/Minimal harm or potential for actual harm
Fire Safety Survey: FIDALGO CARE CENTER
Fire Safety Survey Results: 09/06/2013
Corrected Deficiency Severity
10/14/2013 Corridor and hallway doors that block smoke. Isolated/Minimal harm or potential for actual harm
10/14/2013 Record of quarterly fire drills for each shift under varying conditions. Pattern/Minimal harm or potential for actual harm
10/14/2013 Automatic sprinkler systems that have been maintained in working order. Pattern/Minimal harm or potential for actual harm
10/14/2013 Portable fire extinguishers. Isolated/Minimal harm or potential for actual harm
10/14/2013 Exits that are free from obstructions and can be used at all times. Isolated/Minimal harm or potential for actual harm
10/14/2013 Weekly inspections and monthly testing of generators. Pattern/Minimal harm or potential for actual harm
10/14/2013 Properly installed electrical wiring and equipment. Widespread/Potential for minimal harm
Fire Safety Survey Results: 05/15/2012
Corrected Deficiency Severity
06/18/2012 Automatic sprinkler systems that have been maintained in working order. Isolated/Minimal harm or potential for actual harm
06/19/2012 Properly installed electrical wiring and equipment. Isolated/Minimal harm or potential for actual harm
Fire Safety Survey Results: 06/20/2011
Corrected Deficiency Severity
07/11/2011 An approved installation, maintenance and testing program for fire alarm systems. Isolated/Minimal harm or potential for actual harm
07/11/2011 Proper facilities for the use and storage of combustible liquids. Isolated/Minimal harm or potential for actual harm
07/11/2011 Properly installed electrical wiring and equipment. Isolated/Minimal harm or potential for actual harm

Resident Complaints: FIDALGO CARE CENTER
Date Complaint Substantiated: 12/06/2013
CorrectedCategoryDeficiencySeverity
12/20/2013Ensure that each resident who enters the nursing home without a catheter is not given a catheter, unless medically necessary, and that incontinent patients receive proper services to prevent urinary tract infections and restore normal bladder functions. D
Date Complaint Substantiated: 09/23/2013
CorrectedCategoryDeficiencySeverity
11/01/20131) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. D
11/01/2013Ensure services provided by the nursing facility meet professional standards of quality. D
Date Complaint Substantiated: 07/12/2013
CorrectedCategoryDeficiencySeverity
08/16/2013Ensure that all full-time nurse aids employed for more than 4 months are fully trained and competent to provide nursing and nursing-related services, as defined by Federal requirements. D
08/16/20131) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. D
08/16/2013Ensure residents have the right to have a choice over activities, their schedules, and health care according to their interests, assessments, and plans of care. D
Date Complaint Substantiated: 01/09/2013
CorrectedCategoryDeficiencySeverity
02/23/20131) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents. D
02/23/2013Provide care for residents in a way that maintains or improves their dignity and respect in full recognition of their individuality. G
02/23/2013Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. G

Quality Measures: FIDALGO CARE CENTER
Quality Measures National Average Washington Average FIDALGO CARE CENTER
Overall quality rating NA NA 2
2
Long-Stay Residents
Percent of Long Stay Residents Whose Need for Help with ADLs has Increased 15.4% 13.2% 13.8%
Percent of Long Stay Residents Who Self Report Moderate to Severe Pain 8.3% 10.8% 10.3%
Percent of High Risk Long Stay Residents With Pressure Ulcers 6.1% 5.6% 9.6%
Percent of Long Stay Residents Who Lose Too Much Weight 7.2% 6.6% 6.3%
Percent of Low Risk Long Stay Residents Who Lose Control of Their Bowel or Bladder 43.9% 50.8% 53.1%
Percent of Long Stay Residents with a Catheter Inserted and Left in Their Bladder 3.2% 3.6% 6.5%
Percent of Long Stay Residents With a Urinary Tract Infection 6.2% 6.4% 10.9%
Percent of Long Stay Residents Who Have Depressive Symptoms 6.3% 11.9% 15.4%
Percent of Long Stay Residents Who Were Physically Restrained 1.4% 1.1% 0.0%
Percent of Long Stay Residents Experiencing One or More Falls with Major Injury 3.2% 3.1% 4.3%
Percent of Long Stay Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine 92.7% 91.3% 79.7%
Percent of Long Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 94.3% 95.4% 100.0%
Percent of Long Stay Residents Who Received an Antipsychotic Medication 20.7% 19.4% 17.1%
Short-Stay Residents
Percent of Short Stay Residents Who Self Report Moderate to Severe Pain 19.2% 22.2% 34.4%
Percent of Short Stay Residents With Pressure Ulcers That Are New or Worsened 1.2% 1.0% 2.2%
Percent of Short Stay Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine 83.4% 86.2% 85.4%
Percent of Short Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 82.4% 86.1% 88.7%
Percent of Short Stay Residents Who Newly Received an Antipsychotic Medication 2.6% 2.1% 3.9%

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