Crossroads, The - Davenport Nursing Home
General Information
UPDATEFederal Provider Number
105777
Provider Name
CROSSROADS, THE
Provider Address
206 W ORANGE ST
DAVENPORT, FL 33837
DAVENPORT, FL 33837
Provider Phone Number
8634224961
Provider SSA County
520
Provider County Name
Polk
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
51
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
206 GOLDEN LLC
Date First Approved to Provide Medicare and Medicaid services
1992-06-26
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
4.00490
Reported LPN Staffing Hours per Resident per Day
0.79804
Reported RN Staffing Hours per Resident per Day
0.85392
Reported Licensed Staffing Hours per Resident per Day
1.65196
Reported Total Nurse Staffing Hours per Resident per Day
5.65686
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11176
Expected CNA Staffing Hours per Resident per Day
2.39037
Expected LPN Staffing Hours per Resident per Day
0.73194
Expected RN Staffing Hours per Resident per Day
1.31102
Expected Total Nurse Staffing Hours per Resident per Day
4.43333
Adjusted CNA Staffing Hours per Resident per Day
4.11100
Adjusted LPN Staffing Hours per Resident per Day
0.90496
Adjusted RN Staffing Hours per Resident per Day
0.48668
Adjusted Total Nurse Staffing Hours per Resident per Day
5.14336
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-02-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2012-11-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2011-10-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
12.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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