Signature Healthcare Of Port Charlotte - Port Charlotte Nursing Home
General Information
UPDATEFederal Provider Number
105363
Provider Name
SIGNATURE HEALTHCARE OF PORT CHARLOTTE
Provider Address
4033 BEAVER LANE
PORT CHARLOTTE, FL 33952
PORT CHARLOTTE, FL 33952
Provider Phone Number
(941) 625-3200
Provider SSA County
70
Provider County Name
Charlotte
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
164
Number of Residents in Certified Beds
133
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LP PORT CHARLOTTE LLC
Date First Approved to Provide Medicare and Medicaid services
1980-04-11
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
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.72143
Reported LPN Staffing Hours per Resident per Day
0.89662
Reported RN Staffing Hours per Resident per Day
0.62068
Reported Licensed Staffing Hours per Resident per Day
1.51729
Reported Total Nurse Staffing Hours per Resident per Day
4.23873
Reported Physical Therapist Staffing Hours per Resident Per Day
0.22068
Expected CNA Staffing Hours per Resident per Day
2.52271
Expected LPN Staffing Hours per Resident per Day
0.72909
Expected RN Staffing Hours per Resident per Day
1.28160
Expected Total Nurse Staffing Hours per Resident per Day
4.53340
Adjusted CNA Staffing Hours per Resident per Day
2.64698
Adjusted LPN Staffing Hours per Resident per Day
1.02072
Adjusted RN Staffing Hours per Resident per Day
0.36187
Adjusted Total Nurse Staffing Hours per Resident per Day
3.76889
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
277
Cycle 1 Standard Survey Health Date
2014-06-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
277
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2013-07-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
56
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
76
Cycle 3 Standard Health Survey Date
2012-08-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
76
Total Weighted Health Survey Score
169.83300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
6
Number of Fines
3
Total Amount of Fines in Dollars
51641
Number of Payment Denials
0
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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