Fort Walton Rehabilitation Center, LLC
1 Lbj Sr Drive, Fort Walton Beach, FL 32547


Fort Walton Rehabilitation Center, LLC is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 105295. The address is 1 Lbj Sr Drive, Fort Walton Beach, FL 32547. The zip code is 32547. The phone number is 8508632066.


Fort Walton Rehabilitation Center, LLC · 1 Lbj Sr Drive, Fort Walton Beach, FL 32547

Federal Provider Number 105295
Provider Name FORT WALTON REHABILITATION CENTER, LLC
Address 1 LBJ SR DRIVE
FORT WALTON BEACH, FL 32547
Phone Number 8508632066
SSA County Code 450
County Name Okaloosa
Ownership Type For profit - Corporation
Certified Beds 120
Certified Beds Residents 98
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name FORT WALTON REHABILITATION CENTER, LLC
Date First Approved to Provide Medicare Medicaid Services 12/16/1979
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 5
Health Inspection Rating 5
Quality Measure Rating 4
Staffing Rating 5
RN Staffing Rating 5
Reported CNA Staffing Hours per Resident per Day 2.91429
Reported LPN Staffing Hours per Resident per Day 0.86531
Reported RN Staffing Hours per Resident per Day 1.32092
Reported Licensed Staffing Hours per Resident per Day 2.18622
Reported Total Nurse Staffing Hours per Resident per Day 5.10052
Reported Physical Therapist Staffing Hours per Resident Per Day 0.18163
Expected CNA Staffing Hours per Resident per Day 2.54948
Expected LPN Staffing Hours per Resident per Day 0.63358
Expected RN Staffing Hours per Resident per Day 1.03489
Expected Total Nurse Staffing Hours per Resident per Day 4.21794
Adjusted CNA Staffing Hours per Resident per Day 2.80481
Adjusted LPN Staffing Hours per Resident per Day 1.13357
Adjusted RN Staffing Hours per Resident per Day 0.95372
Adjusted Total Nurse Staffing Hours per Resident per Day 4.87434
Cycle 1 Total Number of Health Deficiencies 3
Cycle 1 Number of Standard Health Deficiencies 3
Cycle 1 Health Deficiency Score 12
Cycle 1 Standard Survey Health Date 05/13/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 12
Cycle 2 Total Number of Health Deficiencies 3
Cycle 2 Number of Standard Health Deficiencies 3
Cycle 2 Health Deficiency Score 12
Cycle 2 Standard Health Survey Date 02/27/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 12
Cycle 3 Total Number of Health Deficiencies 1
Cycle 3 Number of Complaint Health Deficiencies 1
Cycle 3 Health Deficiency Score 4
Cycle 3 Standard Health Survey Date 04/25/2014
Cycle 3 Total Health Score 4
Total Weighted Health Survey Score 10.667
Number of Substantiated Complaints 2
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Fort Walton Rehabilitation Center, LLC

Owner Name Role Association Date
BRUN, ERIC (Individual) MANAGING EMPLOYEE since 12/29/2014
HEALTHCARE FINANCIAL SOLUTIONS, LLC (Organization) 5% OR GREATER SECURITY INTEREST since 12/31/2015
JOHN J NOTERMANN TTEE OF THE NOTERMANN 2015 FAM TR (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
83%
since 12/31/2015
MELTON, DONALD (Individual) MANAGING EMPLOYEE since 02/01/2012
MELTON, DONALD (Individual) OFFICER since 02/01/2012
RCG HOLDING LLC (Organization) 5% OR GREATER SECURITY INTEREST since 12/31/2015
ROYCE MARK CRONQUIST TTEE OF THE CRONQUIST 2015 FAM TR (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
15%
since 12/31/2015
SOUTHERN HEALTHCARE MANAGEMENT, LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 02/01/2012
SOVEREIGN HEALTHCARE HOLDINGS, LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 02/01/2012

32547 · Nursing Home

Westwood Nursing and Rehabilitation Center 1001 Mar-walt Drive, Fort Walton Beach, FL 32547

Fort Walton Beach · Nursing Home

Westwood Nursing and Rehabilitation Center 1001 Mar-walt Drive, Fort Walton Beach, FL 32547
Emerald Coast Center 114 Third Street Se, Fort Walton Beach, FL 32548

FL · Nursing Home

East Orlando Health & Rehab Center Inc 250 South Chickasaw Trail, Orlando, FL 32825
Timberridge Nursing & Rehabilitation Center 9848 Sw 110th St, Ocala, FL 34481
Westminster Towers 70 West Lucerne Circle, Orlando, FL 32801
Kr At College Harbor 4600 54th Ave S, Saint Petersburg, FL 33711
Riviera Palms Rehabilitation Center 926 Haben Blvd, Palmetto, FL 34221
Huntington Place 1775 Huntington Lane, Rockledge, FL 32955
Bayside Care Center 811 Jackson St N, Saint Petersburg, FL 33705
Covenant Village Care Center 9211 W Broward Blvd, Plantation, FL 33324
Lakeland Nursing & Rehabilitation 1919 Lakeland Hills Blvd, Lakeland, FL 33805
Life Care Center of Winter Haven 1510 Cypress Gardens Blvd, Winter Haven, FL 33884
Manorcare Health Services 6931 W Sunrise Blvd, Plantation, FL 33313
Sunnyside Nursing Home 5201 Bahia Vista Street, Sarasota, FL 34232
Jacksonville Nursing and Rehab Center 4134 Dunn Avenue, Jacksonville, FL 32218
Willowbrooke Court Skilled Care Center - Edgewater 23305 Blue Water Circle, Boca Raton, FL 33433
Ocean View Nursing & Rehabilitation Center, LLC 2810 South Atlantic Avenue, New Smyrna Beach, FL 32169
Palmetto Sub Acute Care Center, Inc 7600 Sw 8th Street, Miami, FL 33144
Villa Maria West Skilled Nursing Facility 8850 Nw 122 St, Hialeah Gardens, FL 33018
Glenridge On Palmer Ranch Inc. 7333 Scotland Way, Sarasota, FL 34238
Good Samaritan Center 10676 Marvin Jones Blvd, Live Oak, FL 32060
Villa Maria Nursing Center 1050 Ne 125th Street, North Miami, FL 33161
Bay Pointe Nursing Pavilion 4201 31st St S, Saint Petersburg, FL 33712
St Catherine Laboure Manor, Inc 1750 Stockton St, Jacksonville, FL 32204
Signature Healthcare of Ormond 103 North Clyde Morris Blvd, Ormond Beach, FL 32174
Life Care Center of Port Saint Lucie 3720 Se Jennings Rd, Port Saint Lucie, FL 34952
Darcy Hall of Life Care 2170 Palm Beach Lakes Blvd, West Palm Beach, FL 33409
Page Rehabilitation and Healthcare Center 2310 N Airport Road, Fort Myers, FL 33907
Fairway Oaks Center 13806 N 46th St, Tampa, FL 33613
Sylvan Health Center 2770 Regency Oaks Blvd, Clearwater, FL 33759
Solaris Healthcare Pensacola 8475 University Parkway, Pensacola, FL 32514
Villages Rehabilitation and Nursing Center (the) 900 Highway 466, Lady Lake, FL 32159
Chateau At Moorings Park, The 130 Moorings Park Drive, Naples, FL 34105
Signature Healthcare of Pinellas Park 8701 49th St N, Pinellas Park, FL 33782
Suwannee Health and Rehabilitation Center 1620 Helvenston St Se, Live Oak, FL 32064
Summer Brook Health Care Center 5377 Moncrief Road, Jacksonville, FL 32209
North Campus Rehabilitation and Nursing Center 700 N Palmetto St, Leesburg, FL 34748
Lisenby On Lake Caroline 1400 W 11th St, Panama City, FL 32401
First Coast Health & Rehabilitation Center 7723 Jasper Avenue, Jacksonville, FL 32211
South Tampa Health and Rehabilitation Center 4610 S Manhattan Ave, Tampa, FL 33611
Boca Raton Rehabilitation Center 755 Meadows Road, Boca Raton, FL 33486
University Center West 545 West Euclid Avenue, Deland, FL 32720