Courtenay Springs Village - Merritt Island Nursing Home
General Information
UPDATEFederal Provider Number
105463
Provider Name
COURTENAY SPRINGS VILLAGE
Provider Address
1100 SOUTH COURTENAY PARKWAY
MERRITT ISLAND, FL 32952
MERRITT ISLAND, FL 32952
Provider Phone Number
(321) 452-1233
Provider SSA County
40
Provider County Name
Brevard
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
80
Number of Residents in Certified Beds
75
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MERRITT ISLAND RHF HOUSING, INC
Date First Approved to Provide Medicare and Medicaid services
1984-06-04
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
2
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.32067
Reported LPN Staffing Hours per Resident per Day
0.78067
Reported RN Staffing Hours per Resident per Day
1.21200
Reported Licensed Staffing Hours per Resident per Day
1.99267
Reported Total Nurse Staffing Hours per Resident per Day
5.31334
Reported Physical Therapist Staffing Hours per Resident Per Day
0.16467
Expected CNA Staffing Hours per Resident per Day
2.42307
Expected LPN Staffing Hours per Resident per Day
0.63496
Expected RN Staffing Hours per Resident per Day
1.07464
Expected Total Nurse Staffing Hours per Resident per Day
4.13266
Adjusted CNA Staffing Hours per Resident per Day
3.36265
Adjusted LPN Staffing Hours per Resident per Day
1.02047
Adjusted RN Staffing Hours per Resident per Day
0.84271
Adjusted Total Nurse Staffing Hours per Resident per Day
5.18250
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-11-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
7
Cycle 2 Health Deficiency Score
276
Cycle 2 Standard Health Survey Date
2013-09-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
276
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-08-10
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
20
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
104.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
10
Number of Fines
2
Total Amount of Fines in Dollars
120500
Number of Payment Denials
1
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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