West Jacksonville Health And Rehabilitation Center - Jacksonville Nursing Home
General Information
UPDATEFederal Provider Number
105707
Provider Name
WEST JACKSONVILLE HEALTH AND REHABILITATION CENTER
Provider Address
1650 FOURAKER ROAD
JACKSONVILLE, FL 32221
JACKSONVILLE, FL 32221
Provider Phone Number
(904) 786-8668
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
99
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
IHS OF FLORIDA AT JACKSONVILLE INC
Date First Approved to Provide Medicare and Medicaid services
1990-08-10
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
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
2.90000
Reported LPN Staffing Hours per Resident per Day
0.80051
Reported RN Staffing Hours per Resident per Day
0.57677
Reported Licensed Staffing Hours per Resident per Day
1.37727
Reported Total Nurse Staffing Hours per Resident per Day
4.27728
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14444
Expected CNA Staffing Hours per Resident per Day
2.41321
Expected LPN Staffing Hours per Resident per Day
0.65542
Expected RN Staffing Hours per Resident per Day
1.06130
Expected Total Nurse Staffing Hours per Resident per Day
4.12994
Adjusted CNA Staffing Hours per Resident per Day
2.94866
Adjusted LPN Staffing Hours per Resident per Day
1.01373
Adjusted RN Staffing Hours per Resident per Day
0.40607
Adjusted Total Nurse Staffing Hours per Resident per Day
4.17471
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-10-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2013-09-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
64
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-06-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
42.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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