Fort Walton Rehabilitation Center, Llc - Fort Walton Beach Nursing Home
General Information
UPDATEFederal Provider Number
105295
Provider Name
FORT WALTON REHABILITATION CENTER, LLC
Provider Address
1 LBJ SR DRIVE
FORT WALTON BEACH, FL 32547
FORT WALTON BEACH, FL 32547
Provider Phone Number
(850) 863-2066
Provider SSA County
450
Provider County Name
Okaloosa
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
101
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FORT WALTON REHABILITATION CENTER, LLC
Date First Approved to Provide Medicare and Medicaid services
1979-12-16
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
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.60000
Reported LPN Staffing Hours per Resident per Day
0.75743
Reported RN Staffing Hours per Resident per Day
0.72178
Reported Licensed Staffing Hours per Resident per Day
1.47921
Reported Total Nurse Staffing Hours per Resident per Day
4.07921
Reported Physical Therapist Staffing Hours per Resident Per Day
0.15099
Expected CNA Staffing Hours per Resident per Day
2.58636
Expected LPN Staffing Hours per Resident per Day
0.64040
Expected RN Staffing Hours per Resident per Day
1.05744
Expected Total Nurse Staffing Hours per Resident per Day
4.28420
Adjusted CNA Staffing Hours per Resident per Day
2.46664
Adjusted LPN Staffing Hours per Resident per Day
0.98168
Adjusted RN Staffing Hours per Resident per Day
0.51002
Adjusted Total Nurse Staffing Hours per Resident per Day
3.83803
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2015-02-27
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
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
2014-04-25
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
15
Cycle 3 Number of Standard Health Deficiencies
15
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2013-03-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
18.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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