Lisenby On Lake Caroline - Panama City Nursing Home
General Information
UPDATEFederal Provider Number
10A436
Provider Name
LISENBY ON LAKE CAROLINE
Provider Address
1400 W 11TH ST
PANAMA CITY, FL 32401
PANAMA CITY, FL 32401
Provider Phone Number
(850) 785-6121
Provider SSA County
20
Provider County Name
Bay
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
22
Number of Residents in Certified Beds
21
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1992-11-19
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
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
2.59762
Reported LPN Staffing Hours per Resident per Day
1.26905
Reported RN Staffing Hours per Resident per Day
0.52857
Reported Licensed Staffing Hours per Resident per Day
1.79762
Reported Total Nurse Staffing Hours per Resident per Day
4.39524
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.24723
Expected LPN Staffing Hours per Resident per Day
0.59293
Expected RN Staffing Hours per Resident per Day
0.85858
Expected Total Nurse Staffing Hours per Resident per Day
3.69873
Adjusted CNA Staffing Hours per Resident per Day
2.83629
Adjusted LPN Staffing Hours per Resident per Day
1.77646
Adjusted RN Staffing Hours per Resident per Day
0.46000
Adjusted Total Nurse Staffing Hours per Resident per Day
4.78996
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2015-01-29
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
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2014-03-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2013-05-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
20.66700
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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