Summer Brook Health Care Center - Jacksonville Nursing Home
General Information
UPDATEFederal Provider Number
105138
Provider Name
SUMMER BROOK HEALTH CARE CENTER
Provider Address
5377 MONCRIEF ROAD
JACKSONVILLE, FL 32209
JACKSONVILLE, FL 32209
Provider Phone Number
(904) 768-1506
Provider SSA County
150
Provider County Name
Duval
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
114
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
NORTHERN JACKSONVILLE ACQUISITIONS LLC
Date First Approved to Provide Medicare and Medicaid services
1967-05-09
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
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
3.47851
Reported LPN Staffing Hours per Resident per Day
1.07763
Reported RN Staffing Hours per Resident per Day
0.43114
Reported Licensed Staffing Hours per Resident per Day
1.50877
Reported Total Nurse Staffing Hours per Resident per Day
4.98728
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03114
Expected CNA Staffing Hours per Resident per Day
2.11762
Expected LPN Staffing Hours per Resident per Day
0.53813
Expected RN Staffing Hours per Resident per Day
0.77327
Expected Total Nurse Staffing Hours per Resident per Day
3.42901
Adjusted CNA Staffing Hours per Resident per Day
4.03057
Adjusted LPN Staffing Hours per Resident per Day
1.66212
Adjusted RN Staffing Hours per Resident per Day
0.41661
Adjusted Total Nurse Staffing Hours per Resident per Day
5.86268
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-08-14
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
6
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2014-02-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2013-08-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
31.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
Number of Fines
1
Total Amount of Fines in Dollars
168344
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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