Northwest Florida Community Hospital (snu) - Chipley Nursing Home
General Information
UPDATEFederal Provider Number
106055
Provider Name
NORTHWEST FLORIDA COMMUNITY HOSPITAL (SNU)
Provider Address
1360 BRICKYARD RD
CHIPLEY, FL 32428
CHIPLEY, FL 32428
Provider Phone Number
(850) 415-7400
Provider SSA County
660
Provider County Name
Washington
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
34
Number of Residents in Certified Beds
33
Provider Type
Medicare
Provider Resides in Hospital
Y
Legal Business Name
NORTHWEST FLORIDA HEALTHCARE, INC.
Date First Approved to Provide Medicare and Medicaid services
2003-03-06
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
5
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
2.96970
Reported LPN Staffing Hours per Resident per Day
0.99848
Reported RN Staffing Hours per Resident per Day
0.34242
Reported Licensed Staffing Hours per Resident per Day
1.34091
Reported Total Nurse Staffing Hours per Resident per Day
4.31060
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05909
Expected CNA Staffing Hours per Resident per Day
2.46539
Expected LPN Staffing Hours per Resident per Day
0.57195
Expected RN Staffing Hours per Resident per Day
0.84795
Expected Total Nurse Staffing Hours per Resident per Day
3.88529
Adjusted CNA Staffing Hours per Resident per Day
2.95562
Adjusted LPN Staffing Hours per Resident per Day
1.44897
Adjusted RN Staffing Hours per Resident per Day
0.30174
Adjusted Total Nurse Staffing Hours per Resident per Day
4.47215
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
2014-12-04
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
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-10-02
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-11-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
8.66700
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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Nursiong Homes Nearby
Washington Rehabilitation And Nursing Center
879 Usery Road |
CHIPLEY FL 32428 | 0.1 mile away