Woodland Grove Health & Rehabilitation Center - Jacksonville Nursing Home
General Information
UPDATEFederal Provider Number
106058
Provider Name
WOODLAND GROVE HEALTH & REHABILITATION CENTER
Provider Address
4325 SOUTHPOINT BOULEVARD
JACKSONVILLE, FL 32216
JACKSONVILLE, FL 32216
Provider Phone Number
9042457620
Provider SSA County
150
Provider County Name
Duval
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
WOODLAND GROVE NH LLC
Date First Approved to Provide Medicare and Medicaid services
2004-02-20
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
1
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
2.66930
Reported LPN Staffing Hours per Resident per Day
0.83509
Reported RN Staffing Hours per Resident per Day
0.54693
Reported Licensed Staffing Hours per Resident per Day
1.38202
Reported Total Nurse Staffing Hours per Resident per Day
4.05132
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.28781
Expected LPN Staffing Hours per Resident per Day
0.56101
Expected RN Staffing Hours per Resident per Day
0.91444
Expected Total Nurse Staffing Hours per Resident per Day
3.76326
Adjusted CNA Staffing Hours per Resident per Day
2.86285
Adjusted LPN Staffing Hours per Resident per Day
1.23550
Adjusted RN Staffing Hours per Resident per Day
0.44690
Adjusted Total Nurse Staffing Hours per Resident per Day
4.33945
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-10-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-08-08
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-05-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
36.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
9
Number of Fines
1
Total Amount of Fines in Dollars
1820
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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