Evans Health Care - Fort Myers Nursing Home
General Information
UPDATEFederal Provider Number
106000
Provider Name
EVANS HEALTH CARE
Provider Address
3735 EVANS AVE
FORT MYERS, FL 33901
FORT MYERS, FL 33901
Provider Phone Number
(239) 277-3977
Provider SSA County
350
Provider County Name
Lee
Provider Website
Provider Description
Ownership Type
For 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
3735 EVANS AVENUE OPERATIONS LLC
Date First Approved to Provide Medicare and Medicaid services
1998-12-14
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.53922
Reported LPN Staffing Hours per Resident per Day
0.92543
Reported RN Staffing Hours per Resident per Day
0.42328
Reported Licensed Staffing Hours per Resident per Day
1.34871
Reported Total Nurse Staffing Hours per Resident per Day
3.88793
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09784
Expected CNA Staffing Hours per Resident per Day
2.41835
Expected LPN Staffing Hours per Resident per Day
0.62960
Expected RN Staffing Hours per Resident per Day
1.11186
Expected Total Nurse Staffing Hours per Resident per Day
4.15982
Adjusted CNA Staffing Hours per Resident per Day
2.57633
Adjusted LPN Staffing Hours per Resident per Day
1.21999
Adjusted RN Staffing Hours per Resident per Day
0.28446
Adjusted Total Nurse Staffing Hours per Resident per Day
3.76744
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-08-07
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2014-01-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
286
Cycle 3 Standard Health Survey Date
2013-08-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
286
Total Weighted Health Survey Score
69.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
7
Number of Fines
1
Total Amount of Fines in Dollars
87930
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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