Douglas Jacobson State Veterans Nursing Home - Port Charlotte Nursing Home
General Information
UPDATEFederal Provider Number
106059
Provider Name
DOUGLAS JACOBSON STATE VETERANS NURSING HOME
Provider Address
21281 GRAYTON TERRACE
PORT CHARLOTTE, FL 33954
PORT CHARLOTTE, FL 33954
Provider Phone Number
9416130919
Provider SSA County
70
Provider County Name
Charlotte
Ownership Type
Government - State
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
FLORIDA DEPARTMENT OF VETERANS AFFAIRS
Date First Approved to Provide Medicare and Medicaid services
2004-06-07
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
4
Health Inspection Rating Footnote
QM Rating
5
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
3.99009
Reported LPN Staffing Hours per Resident per Day
1.33233
Reported RN Staffing Hours per Resident per Day
0.97457
Reported Licensed Staffing Hours per Resident per Day
2.30690
Reported Total Nurse Staffing Hours per Resident per Day
6.29699
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04914
Expected CNA Staffing Hours per Resident per Day
2.36011
Expected LPN Staffing Hours per Resident per Day
0.61140
Expected RN Staffing Hours per Resident per Day
0.90871
Expected Total Nurse Staffing Hours per Resident per Day
3.88022
Adjusted CNA Staffing Hours per Resident per Day
4.14832
Adjusted LPN Staffing Hours per Resident per Day
1.80870
Adjusted RN Staffing Hours per Resident per Day
0.80135
Adjusted Total Nurse Staffing Hours per Resident per Day
6.54152
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
8
Cycle 1 Standard Survey Health Date
2014-10-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-10-04
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
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
2012-10-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
17.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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
Nursiong Homes Nearby
Village Place Health And Rehabilitation Center
2370 Harbor Blvd |
PORT CHARLOTTE FL 33952 | 2.3 miles away
Consulate Health Care Of Port Charlotte
18480 Cochran Blvd |
PORT CHARLOTTE FL 33948 | 3.1 miles away
Signature Healthcare Of Port Charlotte
4033 Beaver Lane |
PORT CHARLOTTE FL 33952 | 4.1 miles away
Harbour Health Center
23013 Westchester Blvd |
PORT CHARLOTTE FL 33980 | 4.1 miles away
Charlotte Harbor Healthcare
4000 Kings Hwy |
PORT CHARLOTTE FL 33980 | 4.3 miles away
Port Charlotte Rehabilitation Center
25325 Rampart Blvd |
PORT CHARLOTTE FL 33948 | 4.6 miles away
Life Care Center Of Punta Gorda
450 Shreve Street |
PUNTA GORDA FL 33950 | 7.4 miles away
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