Jacaranda Manor - Saint Petersburg Nursing Home
General Information
UPDATEFederal Provider Number
105390
Provider Name
JACARANDA MANOR
Provider Address
4250 66TH ST N
SAINT PETERSBURG, FL 33709
SAINT PETERSBURG, FL 33709
Provider Phone Number
(727) 546-2405
Provider SSA County
510
Provider County Name
Pinellas
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
299
Number of Residents in Certified Beds
282
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ST.PETERSBURG NURSING HOME, LLC
Date First Approved to Provide Medicare and Medicaid services
1981-08-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.68918
Reported LPN Staffing Hours per Resident per Day
0.98865
Reported RN Staffing Hours per Resident per Day
0.21844
Reported Licensed Staffing Hours per Resident per Day
1.20709
Reported Total Nurse Staffing Hours per Resident per Day
3.89627
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01702
Expected CNA Staffing Hours per Resident per Day
2.33364
Expected LPN Staffing Hours per Resident per Day
0.59238
Expected RN Staffing Hours per Resident per Day
0.88151
Expected Total Nurse Staffing Hours per Resident per Day
3.80752
Adjusted CNA Staffing Hours per Resident per Day
2.82754
Adjusted LPN Staffing Hours per Resident per Day
1.38522
Adjusted RN Staffing Hours per Resident per Day
0.18516
Adjusted Total Nurse Staffing Hours per Resident per Day
4.12485
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-05-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
10
Cycle 2 Health Deficiency Score
389
Cycle 2 Standard Health Survey Date
2013-02-08
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
389
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-01-12
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
20
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
143.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
11
Number of Fines
2
Total Amount of Fines in Dollars
70233
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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