Haven Of Our Lady Of Peace - Pensacola Nursing Home
General Information
UPDATEFederal Provider Number
106052
Provider Name
HAVEN OF OUR LADY OF PEACE
Provider Address
1900 SUMMIT BOULEVARD
PENSACOLA, FL 32503
PENSACOLA, FL 32503
Provider Phone Number
(850) 436-5900
Provider SSA County
160
Provider County Name
Escambia
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
86
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HAVEN OF OUR LADY OF PEACE, INC.
Date First Approved to Provide Medicare and Medicaid services
2003-04-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
2
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
3.50581
Reported LPN Staffing Hours per Resident per Day
1.58023
Reported RN Staffing Hours per Resident per Day
0.95814
Reported Licensed Staffing Hours per Resident per Day
2.53837
Reported Total Nurse Staffing Hours per Resident per Day
6.04418
Reported Physical Therapist Staffing Hours per Resident Per Day
0.13779
Expected CNA Staffing Hours per Resident per Day
2.57969
Expected LPN Staffing Hours per Resident per Day
0.68699
Expected RN Staffing Hours per Resident per Day
1.14926
Expected Total Nurse Staffing Hours per Resident per Day
4.41594
Adjusted CNA Staffing Hours per Resident per Day
3.33458
Adjusted LPN Staffing Hours per Resident per Day
1.90920
Adjusted RN Staffing Hours per Resident per Day
0.62294
Adjusted Total Nurse Staffing Hours per Resident per Day
5.51717
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-06-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
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
2013-04-18
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
1
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-02-16
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
2.66700
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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