Port Orange Nursing And Rehab Center - Port Orange Nursing Home
General Information
UPDATEFederal Provider Number
105776
Provider Name
PORT ORANGE NURSING AND REHAB CENTER
Provider Address
5600 VICTORIA GARDENS BLVD
PORT ORANGE, FL 32127
PORT ORANGE, FL 32127
Provider Phone Number
3867607773
Provider SSA County
630
Provider County Name
Volusia
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
102
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SOVEREIGN HEALTHCARE OF PORT ORANGE LLC
Date First Approved to Provide Medicare and Medicaid services
1992-10-09
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
3
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
2.73971
Reported LPN Staffing Hours per Resident per Day
1.68627
Reported RN Staffing Hours per Resident per Day
0.84755
Reported Licensed Staffing Hours per Resident per Day
2.53382
Reported Total Nurse Staffing Hours per Resident per Day
5.27353
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14559
Expected CNA Staffing Hours per Resident per Day
2.33952
Expected LPN Staffing Hours per Resident per Day
0.68736
Expected RN Staffing Hours per Resident per Day
1.24080
Expected Total Nurse Staffing Hours per Resident per Day
4.26768
Adjusted CNA Staffing Hours per Resident per Day
2.87342
Adjusted LPN Staffing Hours per Resident per Day
2.03621
Adjusted RN Staffing Hours per Resident per Day
0.51039
Adjusted Total Nurse Staffing Hours per Resident per Day
4.98094
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-08-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
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
2013-07-11
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
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
2012-05-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
16.66700
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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