Signature Healthcare Of North Florida - Graceville Nursing Home
General Information
UPDATEFederal Provider Number
105662
Provider Name
SIGNATURE HEALTHCARE OF NORTH FLORIDA
Provider Address
1083 SANDERS AVENUE
GRACEVILLE, FL 32440
GRACEVILLE, FL 32440
Provider Phone Number
(850) 263-4447
Provider SSA County
310
Provider County Name
Jackson
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
180
Number of Residents in Certified Beds
149
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LP GRACEVILLE LLC
Date First Approved to Provide Medicare and Medicaid services
1989-09-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
2
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
2.58255
Reported LPN Staffing Hours per Resident per Day
1.02953
Reported RN Staffing Hours per Resident per Day
0.58893
Reported Licensed Staffing Hours per Resident per Day
1.61846
Reported Total Nurse Staffing Hours per Resident per Day
4.20101
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07517
Expected CNA Staffing Hours per Resident per Day
2.31074
Expected LPN Staffing Hours per Resident per Day
0.59790
Expected RN Staffing Hours per Resident per Day
0.94479
Expected Total Nurse Staffing Hours per Resident per Day
3.85343
Adjusted CNA Staffing Hours per Resident per Day
2.74233
Adjusted LPN Staffing Hours per Resident per Day
1.42919
Adjusted RN Staffing Hours per Resident per Day
0.46576
Adjusted Total Nurse Staffing Hours per Resident per Day
4.39449
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2015-02-05
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-01-09
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
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
2012-12-07
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
0.00000
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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