Palm Terrace Of Clewiston - Clewiston Nursing Home

General Information

UPDATE
Federal Provider Number
105462
Provider Name
PALM TERRACE OF CLEWISTON
Provider Address
301 SOUTH GLORIA STREET
CLEWISTON, FL 33440
Provider Phone Number
8639835123
Provider SSA County
250
Provider County Name
Hendry
Ownership Type
For profit - Corporation
Number of Certified Beds
155
Number of Residents in Certified Beds
120
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SA-CLEWISTON, LLC
Date First Approved to Provide Medicare and Medicaid services
1984-02-01
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
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
2.63250
Reported LPN Staffing Hours per Resident per Day
0.99667
Reported RN Staffing Hours per Resident per Day
0.75875
Reported Licensed Staffing Hours per Resident per Day
1.75542
Reported Total Nurse Staffing Hours per Resident per Day
4.38792
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09542
Expected CNA Staffing Hours per Resident per Day
2.33254
Expected LPN Staffing Hours per Resident per Day
0.61396
Expected RN Staffing Hours per Resident per Day
0.95258
Expected Total Nurse Staffing Hours per Resident per Day
3.89909
Adjusted CNA Staffing Hours per Resident per Day
2.76924
Adjusted LPN Staffing Hours per Resident per Day
1.34737
Adjusted RN Staffing Hours per Resident per Day
0.59516
Adjusted Total Nurse Staffing Hours per Resident per Day
4.53626
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2014-08-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
80
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
84
Cycle 2 Standard Health Survey Date
2013-12-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
6
Cycle 3 Health Deficiency Score
323
Cycle 3 Standard Health Survey Date
2013-05-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
323
Total Weighted Health Survey Score
121.83300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
222900
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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