Community Convalescent Center - Plant City Nursing Home

General Information

UPDATE
Federal Provider Number
105029
Provider Name
COMMUNITY CONVALESCENT CENTER
Provider Address
2202 W OAK AVE
PLANT CITY, FL 33563
Provider Phone Number
8137543761
Provider SSA County
280
Provider County Name
Hillsborough
Ownership Type
Non profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
116
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LTCSP PLANT CITY, LLC
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
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
1
Health Inspection Rating Footnote
QM Rating
4
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
2.56293
Reported LPN Staffing Hours per Resident per Day
0.68103
Reported RN Staffing Hours per Resident per Day
1.01293
Reported Licensed Staffing Hours per Resident per Day
1.69397
Reported Total Nurse Staffing Hours per Resident per Day
4.25689
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12328
Expected CNA Staffing Hours per Resident per Day
2.53621
Expected LPN Staffing Hours per Resident per Day
0.65966
Expected RN Staffing Hours per Resident per Day
1.10518
Expected Total Nurse Staffing Hours per Resident per Day
4.30105
Adjusted CNA Staffing Hours per Resident per Day
2.47955
Adjusted LPN Staffing Hours per Resident per Day
0.85689
Adjusted RN Staffing Hours per Resident per Day
0.68483
Adjusted Total Nurse Staffing Hours per Resident per Day
3.98951
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-08-28
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
10
Cycle 1 Total Health Score
30
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2014-02-12
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
18
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
7
Cycle 3 Health Deficiency Score
689
Cycle 3 Standard Health Survey Date
2013-07-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
689
Total Weighted Health Survey Score
136.50000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
15
Number of Fines
2
Total Amount of Fines in Dollars
31548
Number of Payment Denials
1
Total Number of Penalties
3
Location
Processing Date
2015-06-01

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