Signature Healthcare Of Jacksonville - Jacksonville Nursing Home
General Information
UPDATEFederal Provider Number
105287
Provider Name
SIGNATURE HEALTHCARE OF JACKSONVILLE
Provider Address
2061 HYDE PARK RD
JACKSONVILLE, FL 32210
JACKSONVILLE, FL 32210
Provider Phone Number
(904) 786-7331
Provider SSA County
150
Provider County Name
Duval
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
180
Number of Residents in Certified Beds
152
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LP JACKSONVILLE, LLC
Date First Approved to Provide Medicare and Medicaid services
1979-01-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
2.45132
Reported LPN Staffing Hours per Resident per Day
0.75888
Reported RN Staffing Hours per Resident per Day
0.52072
Reported Licensed Staffing Hours per Resident per Day
1.27961
Reported Total Nurse Staffing Hours per Resident per Day
3.73092
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08520
Expected CNA Staffing Hours per Resident per Day
2.51872
Expected LPN Staffing Hours per Resident per Day
0.60967
Expected RN Staffing Hours per Resident per Day
0.95750
Expected Total Nurse Staffing Hours per Resident per Day
4.08590
Adjusted CNA Staffing Hours per Resident per Day
2.38804
Adjusted LPN Staffing Hours per Resident per Day
1.03313
Adjusted RN Staffing Hours per Resident per Day
0.40635
Adjusted Total Nurse Staffing Hours per Resident per Day
3.68070
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-05-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-03-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2011-12-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
49.33300
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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