Signature Healthcare of North Florida is a nursing home approved by U.S Centers for Medicare & Medicaid Services (CMS). The federal provider number is #105662. The provider type is Medicare and Medicaid. The ownership type is for profit - corporation. The address is 1083 Sanders Avenue, Graceville, FL 32440. The overall rating is 5.
| Federal Provider Number | 105662 |
| Provider Name | SIGNATURE HEALTHCARE OF NORTH FLORIDA |
| Legal Business Name | LP GRACEVILLE LLC |
| Address |
1083 Sanders Avenue Graceville FL 32440 |
| County | Jackson |
| Telephone | 8502634447 |
| Ownership Type | For profit - Corporation |
| Provider Type | Medicare and Medicaid |
| Date Approved | 1989-09-01 |
| Number of Certified Beds | 180 |
| Average Number of Residents per Day | 129.8 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Abuse Icon |
N Cited for abuse or neglect at harm level or above on survey cycle 1 (Scope/severity G or greater) or cited for abuse or neglect at potential harm level (Scope/Severity D or above) on both survey cycles 1 and 2. |
| Most Recent Health Inspection More Than 2 Years Ago | N |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | Resident |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Overall Rating | 5 |
| Health Inspection Rating | 4 |
| Quality Measure Rating | 5 |
| Long Stay Quality Measure Rating | 5 |
| Short Stay Quality Measure Rating | 4 |
| Staffing Rating | 3 |
| Registered Nurses Staffing Rating | 2 |
| Reported CNA Staffing Hours per Resident per Day | 2.68570 |
| Reported LPN Staffing Hours per Resident per Day | 0.90416 |
| Reported RN Staffing Hours per Resident per Day | 0.40977 |
| Reported Licensed Staffing Hours per Resident per Day | 1.31393 |
| Reported Total Nurse Staffing Hours per Resident per Day | 3.99962 |
| Reported Physical Therapist Staffing Hours per Resident Per Day | 0.03795 |
| Expected CNA Staffing Hours per Resident per Day | 1.87250 |
| Expected LPN Staffing Hours per Resident per Day | 0.71033 |
| Expected RN Staffing Hours per Resident per Day | 0.32488 |
| Expected Total Nurse Staffing Hours per Resident per Day | 2.90771 |
| Adjusted CNA Staffing Hours per Resident per Day | 2.95290 |
| Adjusted LPN Staffing Hours per Resident per Day | 0.94308 |
| Adjusted RN Staffing Hours per Resident per Day | 0.50477 |
| Adjusted Total Nurse Staffing Hours per Resident per Day | 4.40154 |
| Rating Cycle 1 Standard Survey Health Date | 2019-08-15 |
| Rating Cycle 1 Total Number of Health Deficiencies | 7 |
| Rating Cycle 1 Number of Standard Health Deficiencies | 7 |
| Rating Cycle 1 Number of Complavarchar Health Deficiencies | 0 |
| Rating Cycle 1 Health Deficiency Score | 32 |
| Rating Cycle 1 Number of Health Revisits | 1 |
| Rating Cycle 1 Health Revisit Score | 0 |
| Rating Cycle 1 Total Health Score | 32 |
| Rating Cycle 2 Standard Health Survey Date | 2018-07-19 |
| Rating Cycle 2 Total Number of Health Deficiencies | 3 |
| Rating Cycle 2 Number of Standard Health Deficiencies | 1 |
| Rating Cycle 2 Number of Complavarchar Health Deficiencies | 2 |
| Rating Cycle 2 Health Deficiency Score | 16 |
| Rating Cycle 2 Number of Health Revisits | 1 |
| Rating Cycle 2 Health Revisit Score | 0 |
| Rating Cycle 2 Total Health Score | 16 |
| Rating Cycle 3 Standard Health Survey Date | 2017-05-25 |
| Rating Cycle 3 Total Number of Health Deficiencies | 0 |
| Rating Cycle 3 Number of Standard Health Deficiencies | 0 |
| Rating Cycle 3 Number of Complavarchar Health Deficiencies | 0 |
| Rating Cycle 3 Health Deficiency Score | 0 |
| Rating Cycle 3 Number of Health Revisits | 0 |
| Rating Cycle 3 Health Revisit Score | 0 |
| Rating Cycle 3 Total Health Score | 0 |
| Total Weighted Health Survey Score | 21.333 |
| Number of Facility Reported Incidents | 1 |
| Number of Substantiated Complavarchars | 1 |
| Number of Citations from Infection Control Inspections | 0 |
| Number of Fines | 0 |
| Total Amount of Fines in Dollars | 0.00 |
| Number of Payment Denials | 0 |
| Total Number of Penalties | 0 |
| Processing Date | 2021-05-01 |
| Notes |
CMS: Centers for Medicare & Medicaid Services CNA: Certified Nursing Assistant LPN: Licensed Practical Nurse RN: Registered Nurse |
| Role Played | Owner Name | Owner Type | Ownership Percentage | Association Date |
|---|---|---|---|---|
| 5% OR GREATER DIRECT OWNERSHIP INTEREST | LP CR HOLDINGS LLC | Organization | 100% | since 11/01/2007 |
| 5% OR GREATER INDIRECT OWNERSHIP INTEREST | AGEMO HOLDINGS, LLC | Organization | NO PERCENTAGE PROVIDED | since 10/01/2016 |
| 5% OR GREATER INDIRECT OWNERSHIP INTEREST | JJLA LLC | Organization | NO PERCENTAGE PROVIDED | since 11/01/2007 |
| 5% OR GREATER INDIRECT OWNERSHIP INTEREST | LPSNF II, LLC | Organization | NO PERCENTAGE PROVIDED | since 10/01/2016 |
| 5% OR GREATER INDIRECT OWNERSHIP INTEREST | SMEDRA, IRA | Individual | NO PERCENTAGE PROVIDED | since 11/01/2007 |
| 5% OR GREATER INDIRECT OWNERSHIP INTEREST | STEIER III, ELMER | Individual | NO PERCENTAGE PROVIDED | since 11/01/2007 |
| 5% OR GREATER INDIRECT OWNERSHIP INTEREST | WHEATEN LLC | Organization | NO PERCENTAGE PROVIDED | since 11/01/2007 |
| 5% OR GREATER INDIRECT OWNERSHIP INTEREST | WINTNER, JACOB | Individual | NO PERCENTAGE PROVIDED | since 11/01/2007 |
| MANAGING EMPLOYEE | NOBLES, BRAD | Individual | since 10/01/2011 | |
| OFFICER | ADAMS, SANDRA | Individual | since 11/01/2007 | |
| OFFICER | HARRISON, JOHN | Individual | since 11/01/2007 | |
| OPERATIONAL/MANAGERIAL CONTROL | ASCHENBECK, JAMES | Individual | since 08/28/2014 | |
| OPERATIONAL/MANAGERIAL CONTROL | CUTLER, DEANNE | Individual | since 07/21/2014 | |
| OPERATIONAL/MANAGERIAL CONTROL | SIGNATURE HEALTHCARE CLINICAL CONSULTING SERVICES LLC | Organization | since 11/01/2007 | |
| OPERATIONAL/MANAGERIAL CONTROL | SIGNATURE HEALTHCARE CONSULTING SERVICES LLC | Organization | since 11/01/2007 | |
| OPERATIONAL/MANAGERIAL CONTROL | SIGNATURE HEALTHCARE LLC | Organization | since 11/01/2007 |
| Street Address |
1083 SANDERS AVENUE |
| City | GRACEVILLE |
| State | FL |
| Zip Code | 32440 |
| Nursing Home Name | Address | Telephone | Date Approved | Overall Rating |
|---|---|---|---|---|
| Essentia Health Grace Home · Graceville Health Center | 116 West Second Street, Graceville, MN 56240 | 3207487223 | 1991-07-08 | 4 |
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| Miami Springs Nursing and Rehabilitation Center · Fair Havens Opco, LLC | 201 Curtiss Pkwy, Miami Springs, FL 33166 | 3058871565 | 2019-09-24 | 2 |
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| Nursing Home Name | Address | Telephone | Date Approved | Overall Rating |
|---|---|---|---|---|
| Signature Healthcare At Colonial Rehab & Wellness · Lp Bardstown LLC | 708 Bartley Avenue, Bardstown, KY 40004 | 5023489260 | 1992-07-01 | 5 |
| Signature Pointe On The Lake Healthcare Community · Lcs-Sp LLC | 14655 Preston Rd, Dallas, TX 75254 | 9727267575 | 1998-06-26 | 4 |
| Signature Healthcare of Primacy · Lp Memphis V, LLC | 6025 Primacy Parkway, Memphis, TN 38119 | 9017671040 | 1981-06-03 | 2 |
| Essentia Health Grace Home · Graceville Health Center | 116 West Second Street, Graceville, MN 56240 | 3207487223 | 1991-07-08 | 4 |
| Signature Healthcare At The Courtyard · Lp Marianna LLC | 2600 Forest Glen Trail, Marianna, FL 32446 | 8505262000 | 1997-08-27 | 5 |
| Signature Healthcare of Whitesburg Gardens · Lp Huntsville, LLC | 105 Teakwood Drive Sw, Huntsville, AL 35801 | 2568815000 | 1972-09-01 | 4 |
| Signature Healthcare of Elizabethtown · Lp E-Town LLC | 1117 Woodland Drive, Elizabethtown, KY 42701 | 2707692363 | 1972-09-01 | 3 |
| Signature Healthcare of Brookwood Gardens · Lp Homestead LLC | 1990 S Canal Drive, Homestead, FL 33035 | 3052461200 | 1987-03-10 | 3 |
| Florida Baptist Retirement Centers Inc. | 1006 33rd St, Vero Beach, FL 32960 | 7725675248 | 2013-03-19 | 5 |
| Signature Healthcare At Hillcrest · Lp Owensboro II, LLC | 3740 Old Hartford Road, Owensboro, KY 42303 | 2706847259 | 1972-09-01 | 5 |
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This dataset includes 15 thousand nursing homes approved by U.S Centers for Medicare & Medicaid Services (CMS) to provide Medicare & Medicaid services. CMS created Care Compare, a healthcare compare tool, for consumers to understand information about doctors, hospitals, and skilled nursing facilities. The information on nursing homes include number of certified beds, quality measure scores, staffing and other information used in the Five-Star Rating System.