Provider Name: CLYDE E LASSEN STATE VETERANS NURSING HOME
Address: 4650 STATE RD 16, SAINT AUGUSTINE, FL 32092
Phone: (904) 940-2193
County: St. Johns (540)
Ownership Type: Government - State
Certified Beds: 120
Average Residents Per Day: 113. ()
Provider Type: Medicare and Medicaid, Resides in Hospital: No
Legal Business Name: FLORIDA DEPARTMENT OF VETERANS AFFAIRS
First Approved Date: March 4, 2011
Affiliated Entity: ()
Retirement Community: N, Special Focus Status:
Ownership Change in Last 12 Months: N
Resident Family Council: Both
Sprinkler System Status: Yes
Overall Rating: 5 ()
Health Inspection Rating: 5 ()
QM Rating: 2 ()
Long Stay QM Rating: 2 ()
Short Stay QM Rating: 3 ()
Staffing Rating: 4 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 3.54502, LPN Staff Hours Per Day: 1.3906, RN Staff Hours Per Day: 0.8604, Licensed Staff Hours Per Day: 2.2510
Total Nurse Staff Hours Per Day, per resident: 5.79605
Weekend Nurse Staff Hours: 4.99151, Weekend RN Staff Hours: 0.4679
PT Staff Hours Per Day, per resident: 0.0388
Nurse Staff Turnover: 63.4, Nurse Turnover Note:
RN Turnover: 58.6, RN Turnover Note:
Admin Left Number: 0, Admin Turnover Note:
Case Mix Nurse Aide Hours Per Day, per resident: 1.9789, Case Mix LPN Hours Per Day: 0.6891, Case Mix RN Hours Per Day: 0.2886
Adjusted Nurse Aide Hours Per Day, per resident: 3.64952, Adjusted LPN Hours Per Day: 1.4891, Adjusted RN Hours Per Day: 1.1233
Total Adjusted Nurse Hours Per Day, per resident: 6.17904
Adjusted Weekend Nurse Hours Per Day, per resident: 5.32134
Health Survey Dates and Scores: Cycle 1: 2023-09-08 (Score: 0), Cycle 2: 2021-11-04 (Score: 20), Cycle 3: 2019-12-05 (Score: 20)
Total Weighted Health Score: 10.000
Reported Incidents: 0, Substantiated Complaints: 0
Infection Control Citations: 0
Fines and Penalties: Number of Fines: 1, Total Fines in Dollars: 2275.00, Payment Denials Number: 0, Total Penalties Number: 1
Location and GPS: 4650 STATE RD 16,SAINT AUGUSTINE,FL,32092 (29.9596, -81.468)
Process Date: 2024-03-01
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:
Type: Health, Deficiency: Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
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 2021-12-17
Type: Health, Deficiency: Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.
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 2021-12-17
Type: Health, Deficiency: Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
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 2021-12-17
Type: Health, Deficiency: Make sure that a working call system is available in each resident's bathroom and bathing area.
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 2021-12-17
Type: Health, Deficiency: Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
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 2020-01-05
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 2020-01-05
Type: Health, Deficiency: Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
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 2020-01-05
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 2020-01-05
Type: Health, Deficiency: Provide and implement an infection prevention and control program.
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 2020-01-05
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:
Type: Fire Safety, Tag: 0345, Version: New
Description: Have approved installation, maintenance and testing program for fire alarm systems.
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 2020-01-05