Signature Healthcare Of Ormond - Ormond Beach Nursing Home
General Information
UPDATEFederal Provider Number
105458
Provider Name
SIGNATURE HEALTHCARE OF ORMOND
Provider Address
103 NORTH CLYDE MORRIS BLVD
ORMOND BEACH, FL 32174
ORMOND BEACH, FL 32174
Provider Phone Number
(386) 673-0450
Provider SSA County
630
Provider County Name
Volusia
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
52
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LP ORMOND BEACH LLC
Date First Approved to Provide Medicare and Medicaid services
1984-02-08
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.61635
Reported LPN Staffing Hours per Resident per Day
1.07019
Reported RN Staffing Hours per Resident per Day
0.45192
Reported Licensed Staffing Hours per Resident per Day
1.52212
Reported Total Nurse Staffing Hours per Resident per Day
4.13846
Reported Physical Therapist Staffing Hours per Resident Per Day
0.20385
Expected CNA Staffing Hours per Resident per Day
2.61000
Expected LPN Staffing Hours per Resident per Day
0.78432
Expected RN Staffing Hours per Resident per Day
1.38926
Expected Total Nurse Staffing Hours per Resident per Day
4.78358
Adjusted CNA Staffing Hours per Resident per Day
2.45967
Adjusted LPN Staffing Hours per Resident per Day
1.13252
Adjusted RN Staffing Hours per Resident per Day
0.24306
Adjusted Total Nurse Staffing Hours per Resident per Day
3.48729
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2015-01-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
23
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
10
Cycle 2 Health Deficiency Score
100
Cycle 2 Standard Health Survey Date
2013-12-05
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
50
Cycle 2 Total Health Score
150
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-11-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
72.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
6
Number of Fines
1
Total Amount of Fines in Dollars
12090
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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