Emory L Bennett Memorial Veterans Nursing Home - Daytona Beach Nursing Home

General Information

UPDATE
Federal Provider Number
105840
Provider Name
EMORY L BENNETT MEMORIAL VETERANS NURSING HOME
Provider Address
1920 MASON AVENUE
DAYTONA BEACH, FL 32117
Provider Phone Number
3862743460
Provider SSA County
630
Provider County Name
Volusia
Ownership Type
Government - State
Number of Certified Beds
120
Number of Residents in Certified Beds
115
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
1994-01-19
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
2
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
3.19565
Reported LPN Staffing Hours per Resident per Day
1.08609
Reported RN Staffing Hours per Resident per Day
0.74435
Reported Licensed Staffing Hours per Resident per Day
1.83043
Reported Total Nurse Staffing Hours per Resident per Day
5.02609
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05609
Expected CNA Staffing Hours per Resident per Day
2.19364
Expected LPN Staffing Hours per Resident per Day
0.61040
Expected RN Staffing Hours per Resident per Day
0.97883
Expected Total Nurse Staffing Hours per Resident per Day
3.78287
Adjusted CNA Staffing Hours per Resident per Day
3.57450
Adjusted LPN Staffing Hours per Resident per Day
1.47683
Adjusted RN Staffing Hours per Resident per Day
0.56821
Adjusted Total Nurse Staffing Hours per Resident per Day
5.35563
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
72
Cycle 1 Standard Survey Health Date
2015-01-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
72
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-02-13
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
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
64
Cycle 3 Standard Health Survey Date
2012-12-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
46.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
10250
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01

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