Governors Creek Health And Rehabilitation - Green Cove Springs Nursing Home
General Information
UPDATEFederal Provider Number
105663
Provider Name
GOVERNORS CREEK HEALTH AND REHABILITATION
Provider Address
803 OAK ST
GREEN COVE SPRINGS, FL 32043
GREEN COVE SPRINGS, FL 32043
Provider Phone Number
(904) 284-5606
Provider SSA County
90
Provider County Name
Clay
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
120
Number of Residents in Certified Beds
118
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
803 OAK STREET OPERATIONS LLC
Date First Approved to Provide Medicare and Medicaid services
1989-07-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
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
2.51102
Reported LPN Staffing Hours per Resident per Day
0.63941
Reported RN Staffing Hours per Resident per Day
0.55932
Reported Licensed Staffing Hours per Resident per Day
1.19873
Reported Total Nurse Staffing Hours per Resident per Day
3.70975
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04958
Expected CNA Staffing Hours per Resident per Day
2.35089
Expected LPN Staffing Hours per Resident per Day
0.72067
Expected RN Staffing Hours per Resident per Day
1.08313
Expected Total Nurse Staffing Hours per Resident per Day
4.15469
Adjusted CNA Staffing Hours per Resident per Day
2.62083
Adjusted LPN Staffing Hours per Resident per Day
0.73641
Adjusted RN Staffing Hours per Resident per Day
0.38585
Adjusted Total Nurse Staffing Hours per Resident per Day
3.59922
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-10-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-09-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-07-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
44.66700
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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