PAVILION AT JACKSONVILLE, THE Nursing Home


PAVILION AT JACKSONVILLE, THE (CCN: 105826) is a For profit - Individual facility located in JACKSONVILLE, FL (32218). The facility has an overall rating of 5/5, health inspection rating of 4/5, and a staffing rating of 2/5. It offers 60 certified beds and maintains an average of 54.2 residents per day. The nursing staff includes Nurse Aides, LPNs, and RNs working 3.48146 total hours per resident per day. It has been certified since August 1, 1993 and the last listed health inspection was on May 12, 2022, The facility is located in Duval county and provides senior and nursing home care.

PAVILION AT JACKSONVILLE, THE Summary


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Provider Name: PAVILION AT JACKSONVILLE, THE

Address: 1771 EDGEWOOD AVE W, JACKSONVILLE, FL 32218

Phone: (904) 766-7436

County: Duval (150)

Ownership Type: For profit - Individual

Certified Beds: 60

Average Residents Per Day: 54.2 ()

Provider Type: Medicare and Medicaid, Resides in Hospital: No

Legal Business Name: THE PAVILION AT JACKSONVILLE FOR NURSING AND REHABILITATION LLC

First Approved Date: August 1, 1993

Affiliated Entity: THE PAVILION GROUP (514)

Retirement Community: N, Special Focus Status:

Ownership Change in Last 12 Months: N

Resident Family Council: Resident

Sprinkler System Status: Yes

Overall Rating: 5 ()

Health Inspection Rating: 4 ()

QM Rating: 5 ()

Long Stay QM Rating: 5 ()

Short Stay QM Rating: 3 ()

Staffing Rating: 2 ()

Staffing Report Note:

PT Staffing Note:

Nurse Aide Staff Hours Per Day, per resident: 2.17176, LPN Staff Hours Per Day: 0.7064, RN Staff Hours Per Day: 0.6033, Licensed Staff Hours Per Day: 1.3096

Total Nurse Staff Hours Per Day, per resident: 3.48146

Weekend Nurse Staff Hours: 3.23120, Weekend RN Staff Hours: 0.5654

PT Staff Hours Per Day, per resident: 0.0963

Nurse Staff Turnover: 68.2, Nurse Turnover Note:

RN Turnover: 57.1, RN Turnover Note:

Admin Left Number: 2, Admin Turnover Note:

Case Mix Nurse Aide Hours Per Day, per resident: 1.8541, Case Mix LPN Hours Per Day: 0.6840, Case Mix RN Hours Per Day: 0.3294

Adjusted Nurse Aide Hours Per Day, per resident: 2.38619, Adjusted LPN Hours Per Day: 0.7620, Adjusted RN Hours Per Day: 0.6899

Total Adjusted Nurse Hours Per Day, per resident: 3.82659

Adjusted Weekend Nurse Hours Per Day, per resident: 3.55153

Health Survey Dates and Scores: Cycle 1: 2022-05-12 (Score: 24), Cycle 2: 2020-10-29 (Score: 0), Cycle 3: 2018-12-13 (Score: 16)

Total Weighted Health Score: 14.667

Reported Incidents: 0, Substantiated Complaints: 0

Infection Control Citations: 0

Fines and Penalties: Number of Fines: 1, Total Fines in Dollars: 650.00, Payment Denials Number: 0, Total Penalties Number: 1

Location and GPS: 1771 EDGEWOOD AVE W,JACKSONVILLE,FL,32218 (30.3861, -81.688)

Process Date: 2024-03-01


Health Inspection Citations Details

Each record details specific health deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:

Citation on 2022-05-12

Type: Health, Deficiency: Ensure each resident’s drug regimen must be free from unnecessary drugs.

Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2022-06-05

Citation on 2022-05-12

Type: Health, Deficiency: Ensure that residents are free from significant medication errors.

Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2022-06-05

Citation on 2022-05-12

Type: Health, Deficiency: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2022-06-05

Citation on 2018-12-13

Type: Health, Deficiency: Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2019-01-22

Citation on 2018-12-13

Type: Health, Deficiency: Ensure medication error rates are not 5 percent or greater.

Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2019-01-22

Citation on 2018-12-13

Type: Health, Deficiency: Ensure that residents are free from significant medication errors.

Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2019-01-22

Citation on 2018-12-13

Type: Health, Deficiency: Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2019-01-22


Fire Safety Citations Details

Each record details specific fire safety deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:

Citation on 2020-10-27

Type: Fire Safety, Tag: 0345, Version: New

Description: Have approved installation, maintenance and testing program for fire alarm systems.

Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2020-11-18

Citation on 2020-10-27

Type: Fire Safety, Tag: 0372, Version: New

Description: Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2020-11-18

Citation on 2020-10-27

Type: Fire Safety, Tag: 0753, Version: New

Description: Have restrictions on the use of highly flammable decorations.

Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2020-11-18

Citation on 2020-10-27

Type: Fire Safety, Tag: 0923, Version: New

Description: Have proper medical gas storage and administration areas.

Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2020-11-18

Citation on 2018-12-12

Type: Fire Safety, Tag: 0023, Version: New

Description: Establish policies and procedures for medical documentation.

Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2019-01-22

Citation on 2018-12-12

Type: Fire Safety, Tag: 0024, Version: New

Description: Establish policies and procedures for volunteers.

Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2019-01-22

Citation on 2018-12-12

Type: Fire Safety, Tag: 0026, Version: New

Description: Establish roles under a Waiver declared by secretary.

Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2019-01-22

Citation on 2018-12-12

Type: Fire Safety, Tag: 0919, Version: New

Description: Meet requirements for the use of electrical equipment.

Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.

Corrected: Deficient, Provider has date of correction on 2019-01-22