Adventhealth Care Center Waterman is a nursing home approved by U.S Centers for Medicare & Medicaid Services (CMS). The federal provider number is #106119. The provider type is Medicare and Medicaid. The ownership type is non profit - corporation. The address is 4501 Waterman Way, Tavares, FL 32778. The overall rating is 5.
| Federal Provider Number | 106119 |
| Provider Name | ADVENTHEALTH CARE CENTER WATERMAN |
| Legal Business Name | FOUNTAIN INN NURSING & REHABILITATION CENTER, INC. |
| Address |
4501 Waterman Way Tavares FL 32778 |
| County | Lake |
| Telephone | 3526094000 |
| Ownership Type | Non profit - Corporation |
| Provider Type | Medicare and Medicaid |
| Date Approved | 2018-10-15 |
| Number of Certified Beds | 120 |
| Average Number of Residents per Day | 93.3 |
| 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 | 5 |
| Quality Measure Rating | 4 |
| Long Stay Quality Measure Rating | 4 |
| Short Stay Quality Measure Rating | 4 |
| Staffing Rating | 4 |
| Registered Nurses Staffing Rating | 3 |
| Reported CNA Staffing Hours per Resident per Day | 2.83555 |
| Reported LPN Staffing Hours per Resident per Day | 1.91072 |
| Reported RN Staffing Hours per Resident per Day | 0.56533 |
| Reported Licensed Staffing Hours per Resident per Day | 2.47606 |
| Reported Total Nurse Staffing Hours per Resident per Day | 5.31161 |
| Reported Physical Therapist Staffing Hours per Resident Per Day | 0.10144 |
| Expected CNA Staffing Hours per Resident per Day | 1.97992 |
| Expected LPN Staffing Hours per Resident per Day | 0.70423 |
| Expected RN Staffing Hours per Resident per Day | 0.31382 |
| Expected Total Nurse Staffing Hours per Resident per Day | 2.99797 |
| Adjusted CNA Staffing Hours per Resident per Day | 2.94851 |
| Adjusted LPN Staffing Hours per Resident per Day | 2.01026 |
| Adjusted RN Staffing Hours per Resident per Day | 0.72093 |
| Adjusted Total Nurse Staffing Hours per Resident per Day | 5.66938 |
| Rating Cycle 1 Standard Survey Health Date | 2019-11-07 |
| Rating Cycle 1 Total Number of Health Deficiencies | 2 |
| Rating Cycle 1 Number of Standard Health Deficiencies | 2 |
| Rating Cycle 1 Number of Complavarchar Health Deficiencies | 0 |
| Rating Cycle 1 Health Deficiency Score | 8 |
| Rating Cycle 1 Number of Health Revisits | 1 |
| Rating Cycle 1 Health Revisit Score | 0 |
| Rating Cycle 1 Total Health Score | 8 |
| Rating Cycle 2 Standard Health Survey Date | 2018-10-15 |
| Rating Cycle 2 Total Number of Health Deficiencies | 0 |
| Rating Cycle 2 Number of Standard Health Deficiencies | 0 |
| Rating Cycle 2 Number of Complavarchar Health Deficiencies | 0 |
| Rating Cycle 2 Health Deficiency Score | 0 |
| Rating Cycle 2 Number of Health Revisits | 0 |
| Rating Cycle 2 Health Revisit Score | 0 |
| Rating Cycle 2 Total Health Score | 0 |
| Total Weighted Health Survey Score | 4.800 |
| Number of Facility Reported Incidents | 0 |
| Number of Substantiated Complavarchars | 2 |
| Number of Citations from Infection Control Inspections | 0 |
| Number of Fines | 1 |
| Total Amount of Fines in Dollars | 13905.00 |
| Number of Payment Denials | 0 |
| Total Number of Penalties | 1 |
| 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 | SUNBELT HEALTH CARE CENTERS INC | Organization | 100% | since 10/24/2014 |
| DIRECTOR | BEAULIEU, TIMOTHY | Individual | since 07/10/2018 | |
| DIRECTOR | HINDS, NIGEL | Individual | since 12/03/2020 | |
| DIRECTOR | JOHNSON, SANDRA | Individual | since 01/01/2017 | |
| DIRECTOR | MCDONALD, RAYMOND | Individual | since 10/24/2014 | |
| DIRECTOR | MUSGRAVE, LISA | Individual | since 12/03/2020 | |
| DIRECTOR | PETTIJOHN, KELLY | Individual | since 02/03/2020 | |
| DIRECTOR | THOMPSON, MICHAEL | Individual | since 07/10/2018 | |
| DIRECTOR | YOUNG, ANITA | Individual | since 12/19/2019 | |
| MANAGING EMPLOYEE | DIETZ, DAVID | Individual | since 11/02/2020 | |
| OFFICER | ADDISCOTT, LYNN | Individual | since 10/24/2014 | |
| OFFICER | BLOCK, LOUIS | Individual | since 10/24/2014 | |
| OFFICER | GRAFF, JEFFREY | Individual | since 11/12/2015 | |
| OFFICER | HINDS, NIGEL | Individual | since 04/01/2018 | |
| OFFICER | HUFFMAN, DAVID | Individual | since 12/03/2020 | |
| OFFICER | JOHNSON, SANDRA | Individual | since 01/01/2017 | |
| OFFICER | PETTIJOHN, KELLY | Individual | since 02/13/2020 | |
| OFFICER | RATHBUN, PAUL | Individual | since 10/24/2014 | |
| OFFICER | RODMAN, DAVID | Individual | since 10/24/2014 | |
| OFFICER | SAUNDERS, MICHAEL | Individual | since 10/24/2014 |
| Street Address |
4501 WATERMAN WAY |
| City | TAVARES |
| State | FL |
| Zip Code | 32778 |
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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.