Signature Healthcare Of Orange Park - Orange Park Nursing Home
General Information
UPDATEFederal Provider Number
105381
Provider Name
SIGNATURE HEALTHCARE OF ORANGE PARK
Provider Address
2029 PROFESSIONAL CENTER DR
ORANGE PARK, FL 32073
ORANGE PARK, FL 32073
Provider Phone Number
(904) 272-6194
Provider SSA County
90
Provider County Name
Clay
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
105
Number of Residents in Certified Beds
99
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LP ORANGE PARK LLC
Date First Approved to Provide Medicare and Medicaid services
1981-02-20
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
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
2.43081
Reported LPN Staffing Hours per Resident per Day
0.79495
Reported RN Staffing Hours per Resident per Day
0.58485
Reported Licensed Staffing Hours per Resident per Day
1.37980
Reported Total Nurse Staffing Hours per Resident per Day
3.81061
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11263
Expected CNA Staffing Hours per Resident per Day
2.47151
Expected LPN Staffing Hours per Resident per Day
0.66244
Expected RN Staffing Hours per Resident per Day
1.11032
Expected Total Nurse Staffing Hours per Resident per Day
4.24427
Adjusted CNA Staffing Hours per Resident per Day
2.41329
Adjusted LPN Staffing Hours per Resident per Day
0.99603
Adjusted RN Staffing Hours per Resident per Day
0.39358
Adjusted Total Nurse Staffing Hours per Resident per Day
3.61904
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2015-01-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-12-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-10-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
22.00000
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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