Fannie E Taylor Home For The Aged Inc - Jacksonville Nursing Home
General Information
UPDATEFederal Provider Number
105820
Provider Name
FANNIE E TAYLOR HOME FOR THE AGED INC
Provider Address
3937 SPRING PARK ROAD
JACKSONVILLE, FL 32207
JACKSONVILLE, FL 32207
Provider Phone Number
9047376777
Provider SSA County
150
Provider County Name
Duval
Ownership Type
Non profit - Corporation
Number of Certified Beds
24
Number of Residents in Certified Beds
23
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
THE FANNIE E. TAYLOR HOME FOR THE AGED, INC.
Date First Approved to Provide Medicare and Medicaid services
1993-07-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
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
2.72826
Reported LPN Staffing Hours per Resident per Day
1.32609
Reported RN Staffing Hours per Resident per Day
0.73261
Reported Licensed Staffing Hours per Resident per Day
2.05870
Reported Total Nurse Staffing Hours per Resident per Day
4.78696
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03043
Expected CNA Staffing Hours per Resident per Day
2.40817
Expected LPN Staffing Hours per Resident per Day
0.53309
Expected RN Staffing Hours per Resident per Day
0.78416
Expected Total Nurse Staffing Hours per Resident per Day
3.72542
Adjusted CNA Staffing Hours per Resident per Day
2.77984
Adjusted LPN Staffing Hours per Resident per Day
2.06469
Adjusted RN Staffing Hours per Resident per Day
0.69808
Adjusted Total Nurse Staffing Hours per Resident per Day
5.17948
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-10-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-11-27
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
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-10-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
21.33300
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
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