Clyde E Lassen State Veterans Nursing Home - Saint Augustine Nursing Home
General Information
UPDATEFederal Provider Number
106088
Provider Name
CLYDE E LASSEN STATE VETERANS NURSING HOME
Provider Address
4650 STATE RD 16
SAINT AUGUSTINE, FL 32092
SAINT AUGUSTINE, FL 32092
Provider Phone Number
(904) 940-2193
Provider SSA County
540
Provider County Name
St. Johns
Provider Website
Provider Description
Ownership Type
Government - State
Number of Certified Beds
120
Number of Residents in Certified Beds
117
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FLORIDA DEPARTMENT OF VETERANS AFFAIRS
Date First Approved to Provide Medicare and Medicaid services
2011-03-04
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
5
Overall Rating Footnote
Health Inspection Rating
5
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
3.87179
Reported LPN Staffing Hours per Resident per Day
1.16667
Reported RN Staffing Hours per Resident per Day
0.83718
Reported Licensed Staffing Hours per Resident per Day
2.00385
Reported Total Nurse Staffing Hours per Resident per Day
5.87564
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05427
Expected CNA Staffing Hours per Resident per Day
2.27928
Expected LPN Staffing Hours per Resident per Day
0.62221
Expected RN Staffing Hours per Resident per Day
0.95360
Expected Total Nurse Staffing Hours per Resident per Day
3.85509
Adjusted CNA Staffing Hours per Resident per Day
4.16807
Adjusted LPN Staffing Hours per Resident per Day
1.55629
Adjusted RN Staffing Hours per Resident per Day
0.65598
Adjusted Total Nurse Staffing Hours per Resident per Day
6.14359
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-05-22
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
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
2013-04-11
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
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-02-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
6.00000
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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