St Catherine Laboure Manor, Inc - Jacksonville Nursing Home
General Information
UPDATEFederal Provider Number
105358
Provider Name
ST CATHERINE LABOURE MANOR, INC
Provider Address
1750 STOCKTON ST
JACKSONVILLE, FL 32204
JACKSONVILLE, FL 32204
Provider Phone Number
(904) 308-4700
Provider SSA County
150
Provider County Name
Duval
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
240
Number of Residents in Certified Beds
232
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ST CATHERINE LABOURE MANOR INC
Date First Approved to Provide Medicare and Medicaid services
1979-08-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.66228
Reported LPN Staffing Hours per Resident per Day
0.92328
Reported RN Staffing Hours per Resident per Day
1.02823
Reported Licensed Staffing Hours per Resident per Day
1.95151
Reported Total Nurse Staffing Hours per Resident per Day
4.61379
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10754
Expected CNA Staffing Hours per Resident per Day
2.49213
Expected LPN Staffing Hours per Resident per Day
0.63322
Expected RN Staffing Hours per Resident per Day
1.01036
Expected Total Nurse Staffing Hours per Resident per Day
4.13571
Adjusted CNA Staffing Hours per Resident per Day
2.62123
Adjusted LPN Staffing Hours per Resident per Day
1.21020
Adjusted RN Staffing Hours per Resident per Day
0.76042
Adjusted Total Nurse Staffing Hours per Resident per Day
4.49686
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2015-04-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2014-03-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2013-01-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
23.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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