Moultrie Creek Nursing And Rehab Center - Saint Augustine Nursing Home
General Information
UPDATEFederal Provider Number
105548
Provider Name
MOULTRIE CREEK NURSING AND REHAB CENTER
Provider Address
200 MARINER HEALTH WAY
SAINT AUGUSTINE, FL 32086
SAINT AUGUSTINE, FL 32086
Provider Phone Number
(904) 797-1800
Provider SSA County
540
Provider County Name
St. Johns
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
106
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SOVEREIGN HEALTHCARE OF ST AUGUSTINE LLC
Date First Approved to Provide Medicare and Medicaid services
1986-12-09
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
4
Overall Rating Footnote
Health Inspection Rating
4
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
2.90566
Reported LPN Staffing Hours per Resident per Day
0.92877
Reported RN Staffing Hours per Resident per Day
0.92170
Reported Licensed Staffing Hours per Resident per Day
1.85047
Reported Total Nurse Staffing Hours per Resident per Day
4.75613
Reported Physical Therapist Staffing Hours per Resident Per Day
0.13491
Expected CNA Staffing Hours per Resident per Day
2.57611
Expected LPN Staffing Hours per Resident per Day
0.67161
Expected RN Staffing Hours per Resident per Day
1.18194
Expected Total Nurse Staffing Hours per Resident per Day
4.42966
Adjusted CNA Staffing Hours per Resident per Day
2.76759
Adjusted LPN Staffing Hours per Resident per Day
1.14781
Adjusted RN Staffing Hours per Resident per Day
0.58268
Adjusted Total Nurse Staffing Hours per Resident per Day
4.32798
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
2014-11-13
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
7
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
28
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
28
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-08-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
15.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
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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