St Mark Village - Palm Harbor Nursing Home

General Information

UPDATE
Federal Provider Number
105378
Provider Name
ST MARK VILLAGE
Provider Address
2655 NEBRASKA AVE
PALM HARBOR, FL 34684
Provider Phone Number
(727) 785-2577
Provider SSA County
510
Provider County Name
Pinellas
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
80
Number of Residents in Certified Beds
55
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ST MARK VILLAGE INC
Date First Approved to Provide Medicare and Medicaid services
1980-11-24
Continuing Care Retirement Community
Y
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
4
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
3.54636
Reported LPN Staffing Hours per Resident per Day
1.57636
Reported RN Staffing Hours per Resident per Day
0.51909
Reported Licensed Staffing Hours per Resident per Day
2.09545
Reported Total Nurse Staffing Hours per Resident per Day
5.64181
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08818
Expected CNA Staffing Hours per Resident per Day
2.79997
Expected LPN Staffing Hours per Resident per Day
0.64444
Expected RN Staffing Hours per Resident per Day
0.96958
Expected Total Nurse Staffing Hours per Resident per Day
4.41399
Adjusted CNA Staffing Hours per Resident per Day
3.10778
Adjusted LPN Staffing Hours per Resident per Day
2.03025
Adjusted RN Staffing Hours per Resident per Day
0.40003
Adjusted Total Nurse Staffing Hours per Resident per Day
5.15215
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-04-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-02-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2011-11-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
25.33300
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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