Moosehaven - Orange Park Nursing Home
General Information
UPDATEFederal Provider Number
106077
Provider Name
MOOSEHAVEN
Provider Address
1701 PARK AVENUE
ORANGE PARK, FL 32073
ORANGE PARK, FL 32073
Provider Phone Number
(904) 278-1200
Provider SSA County
90
Provider County Name
Clay
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
54
Number of Residents in Certified Beds
33
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MOOSEHAVEN INC
Date First Approved to Provide Medicare and Medicaid services
2008-06-24
Continuing Care Retirement Community
Y
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.13333
Reported LPN Staffing Hours per Resident per Day
0.76667
Reported RN Staffing Hours per Resident per Day
0.78030
Reported Licensed Staffing Hours per Resident per Day
1.54697
Reported Total Nurse Staffing Hours per Resident per Day
4.68030
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11667
Expected CNA Staffing Hours per Resident per Day
2.74600
Expected LPN Staffing Hours per Resident per Day
0.71226
Expected RN Staffing Hours per Resident per Day
1.12182
Expected Total Nurse Staffing Hours per Resident per Day
4.58007
Adjusted CNA Staffing Hours per Resident per Day
2.79980
Adjusted LPN Staffing Hours per Resident per Day
0.89340
Adjusted RN Staffing Hours per Resident per Day
0.51973
Adjusted Total Nurse Staffing Hours per Resident per Day
4.11911
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-08-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-06-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
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
20
Cycle 3 Standard Health Survey Date
2012-04-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
22.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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