Haines City Health Care - Haines City Nursing Home
General Information
UPDATEFederal Provider Number
105442
Provider Name
HAINES CITY HEALTH CARE
Provider Address
409 S 10TH ST
HAINES CITY, FL 33844
HAINES CITY, FL 33844
Provider Phone Number
(863) 422-8656
Provider SSA County
520
Provider County Name
Polk
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
97
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
M-K OF HAINES CITY L L C
Date First Approved to Provide Medicare and Medicaid services
1983-12-14
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
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
3.06031
Reported LPN Staffing Hours per Resident per Day
0.98093
Reported RN Staffing Hours per Resident per Day
0.61907
Reported Licensed Staffing Hours per Resident per Day
1.60000
Reported Total Nurse Staffing Hours per Resident per Day
4.66031
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01340
Expected CNA Staffing Hours per Resident per Day
2.87917
Expected LPN Staffing Hours per Resident per Day
0.75065
Expected RN Staffing Hours per Resident per Day
1.07456
Expected Total Nurse Staffing Hours per Resident per Day
4.70437
Adjusted CNA Staffing Hours per Resident per Day
2.60807
Adjusted LPN Staffing Hours per Resident per Day
1.08463
Adjusted RN Staffing Hours per Resident per Day
0.43047
Adjusted Total Nurse Staffing Hours per Resident per Day
3.99315
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
7
Cycle 1 Health Deficiency Score
432
Cycle 1 Standard Survey Health Date
2014-12-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
432
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-10-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-07-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
235.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
Number of Fines
1
Total Amount of Fines in Dollars
29050
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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