Grace Healthcare Of Lake Wales - Lake Wales Nursing Home
General Information
UPDATEFederal Provider Number
106069
Provider Name
GRACE HEALTHCARE OF LAKE WALES
Provider Address
730 N SCENIC HWY
LAKE WALES, FL 33853
LAKE WALES, FL 33853
Provider Phone Number
(863) 676-1512
Provider SSA County
520
Provider County Name
Polk
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
74
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LAKE WALES HEALTHCARE LLC
Date First Approved to Provide Medicare and Medicaid services
2006-03-15
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
2
Health Inspection Rating Footnote
QM Rating
5
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
2.66081
Reported LPN Staffing Hours per Resident per Day
1.08108
Reported RN Staffing Hours per Resident per Day
0.68851
Reported Licensed Staffing Hours per Resident per Day
1.76959
Reported Total Nurse Staffing Hours per Resident per Day
4.43040
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03311
Expected CNA Staffing Hours per Resident per Day
2.51847
Expected LPN Staffing Hours per Resident per Day
0.58518
Expected RN Staffing Hours per Resident per Day
0.94666
Expected Total Nurse Staffing Hours per Resident per Day
4.05031
Adjusted CNA Staffing Hours per Resident per Day
2.59238
Adjusted LPN Staffing Hours per Resident per Day
1.53337
Adjusted RN Staffing Hours per Resident per Day
0.54344
Adjusted Total Nurse Staffing Hours per Resident per Day
4.40917
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-11-07
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-09-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-06-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
38.00000
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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