Spring Lake Rehabilitation Center
1540 6th St Nw, Winter Haven, FL 33881


Spring Lake Rehabilitation Center is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 105730. The address is 1540 6th St Nw, Winter Haven, FL 33881. The zip code is 33881. The phone number is 8632943055.


Spring Lake Rehabilitation Center · 1540 6th St Nw, Winter Haven, FL 33881

Federal Provider Number 105730
Provider Name SPRING LAKE REHABILITATION CENTER
Address 1540 6TH ST NW
WINTER HAVEN, FL 33881
Phone Number 8632943055
SSA County Code 520
County Name Polk
Ownership Type For profit - Corporation
Certified Beds 120
Certified Beds Residents 117
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name SPRING LAKE NC, LLC
Date First Approved to Provide Medicare Medicaid Services 05/17/1991
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 Both
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 5
Health Inspection Rating 3
Quality Measure Rating 5
Staffing Rating 4
RN Staffing Rating 3
Reported CNA Staffing Hours per Resident per Day 2.64915
Reported LPN Staffing Hours per Resident per Day 1.14658
Reported RN Staffing Hours per Resident per Day 0.91795
Reported Licensed Staffing Hours per Resident per Day 2.06453
Reported Total Nurse Staffing Hours per Resident per Day 4.71368
Reported Physical Therapist Staffing Hours per Resident Per Day 0.45043
Expected CNA Staffing Hours per Resident per Day 2.31937
Expected LPN Staffing Hours per Resident per Day 0.75599
Expected RN Staffing Hours per Resident per Day 1.45887
Expected Total Nurse Staffing Hours per Resident per Day 4.53423
Adjusted CNA Staffing Hours per Resident per Day 2.80258
Adjusted LPN Staffing Hours per Resident per Day 1.25883
Adjusted RN Staffing Hours per Resident per Day 0.47015
Adjusted Total Nurse Staffing Hours per Resident per Day 4.19043
Cycle 1 Total Number of Health Deficiencies 13
Cycle 1 Number of Standard Health Deficiencies 7
Cycle 1 Number of Complaint Health Deficiencies 6
Cycle 1 Health Deficiency Score 52
Cycle 1 Standard Survey Health Date 06/16/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 52
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 02/13/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 12
Cycle 3 Total Number of Health Deficiencies 7
Cycle 3 Number of Standard Health Deficiencies 6
Cycle 3 Number of Complaint Health Deficiencies 1
Cycle 3 Health Deficiency Score 20
Cycle 3 Standard Health Survey Date 08/21/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 20
Total Weighted Health Survey Score 33.333
Number of Substantiated Complaints 10
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Spring Lake Rehabilitation Center

Owner Name Role Association Date
CLEAR CHOICE HEALTH CARE LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 10/01/2007
KELLETT, SAMUEL (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
100%
since 12/01/2003
KENNEDY, DEBORAH (Individual) OPERATIONAL/MANAGERIAL CONTROL since 12/01/2003
MELTON, DANIEL (Individual) MANAGING EMPLOYEE since 06/27/2014
SBK CAPITAL, LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
99%
since 12/01/2003

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