Senior Care Of Jacksonville - Jacksonville Nursing Home
General Information
UPDATEFederal Provider Number
676102
Provider Name
SENIOR CARE OF JACKSONVILLE
Provider Address
810 BELAIRE STREET
JACKSONVILLE, TX 75766
JACKSONVILLE, TX 75766
Provider Phone Number
(903) 589-5300
Provider SSA County
281
Provider County Name
Cherokee
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
101
Number of Residents in Certified Beds
79
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
JACKSONVILLE SCC, LLC
Date First Approved to Provide Medicare and Medicaid services
2006-05-15
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
5
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
1.90190
Reported LPN Staffing Hours per Resident per Day
1.02532
Reported RN Staffing Hours per Resident per Day
0.78671
Reported Licensed Staffing Hours per Resident per Day
1.81203
Reported Total Nurse Staffing Hours per Resident per Day
3.71393
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05253
Expected CNA Staffing Hours per Resident per Day
2.73866
Expected LPN Staffing Hours per Resident per Day
0.67797
Expected RN Staffing Hours per Resident per Day
1.11632
Expected Total Nurse Staffing Hours per Resident per Day
4.53295
Adjusted CNA Staffing Hours per Resident per Day
1.70400
Adjusted LPN Staffing Hours per Resident per Day
1.25525
Adjusted RN Staffing Hours per Resident per Day
0.52658
Adjusted Total Nurse Staffing Hours per Resident per Day
3.30259
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-10-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
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
32
Cycle 2 Standard Health Survey Date
2013-12-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-12-05
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
16.66700
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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