Jacksonville Nursing And Rehab Center - Jacksonville Nursing Home
General Information
UPDATEFederal Provider Number
105710
Provider Name
JACKSONVILLE NURSING AND REHAB CENTER
Provider Address
4134 DUNN AVENUE
JACKSONVILLE, FL 32218
JACKSONVILLE, FL 32218
Provider Phone Number
(904) 766-2297
Provider SSA County
150
Provider County Name
Duval
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
163
Number of Residents in Certified Beds
157
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SOVEREIGN HEALTHCARE OF JACKSONVILLE, LLC
Date First Approved to Provide Medicare and Medicaid services
1990-10-31
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
2
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.99299
Reported LPN Staffing Hours per Resident per Day
1.10382
Reported RN Staffing Hours per Resident per Day
0.42420
Reported Licensed Staffing Hours per Resident per Day
1.52803
Reported Total Nurse Staffing Hours per Resident per Day
4.52101
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05414
Expected CNA Staffing Hours per Resident per Day
2.25907
Expected LPN Staffing Hours per Resident per Day
0.62259
Expected RN Staffing Hours per Resident per Day
1.01066
Expected Total Nurse Staffing Hours per Resident per Day
3.89232
Adjusted CNA Staffing Hours per Resident per Day
3.25085
Adjusted LPN Staffing Hours per Resident per Day
1.47154
Adjusted RN Staffing Hours per Resident per Day
0.31362
Adjusted Total Nurse Staffing Hours per Resident per Day
4.68197
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-12-18
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
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
2014-01-09
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
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-11-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
24.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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