Northwest Florida Community Hospital (snu)
1360 Brickyard Rd, Chipley, FL 32428


Northwest Florida Community Hospital (snu) is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 106055. The address is 1360 Brickyard Rd, Chipley, FL 32428. The zip code is 32428. The phone number is 8504157400.


Northwest Florida Community Hospital (snu) · 1360 Brickyard Rd, Chipley, FL 32428

Federal Provider Number 106055
Provider Name NORTHWEST FLORIDA COMMUNITY HOSPITAL (SNU)
Address 1360 BRICKYARD RD
CHIPLEY, FL 32428
Phone Number 8504157400
SSA County Code 660
County Name Washington
Ownership Type For profit - Corporation
Certified Beds 34
Certified Beds Residents 29
Provider Type Medicare
Resides in Hospital true
Legal Business Name NORTHWEST FLORIDA HEALTHCARE, INC.
Date First Approved to Provide Medicare Medicaid Services 03/06/2003
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 5
Quality Measure Rating 2
Staffing Rating 3
RN Staffing Rating 1
Reported CNA Staffing Hours per Resident per Day 2.91379
Reported LPN Staffing Hours per Resident per Day 2.00862
Reported RN Staffing Hours per Resident per Day 0.30517
Reported Licensed Staffing Hours per Resident per Day 2.31379
Reported Total Nurse Staffing Hours per Resident per Day 5.22758
Reported Physical Therapist Staffing Hours per Resident Per Day 0.04483
Expected CNA Staffing Hours per Resident per Day 2.39235
Expected LPN Staffing Hours per Resident per Day 0.57013
Expected RN Staffing Hours per Resident per Day 0.88318
Expected Total Nurse Staffing Hours per Resident per Day 3.84566
Adjusted CNA Staffing Hours per Resident per Day 2.98851
Adjusted LPN Staffing Hours per Resident per Day 2.92417
Adjusted RN Staffing Hours per Resident per Day 0.25818
Adjusted Total Nurse Staffing Hours per Resident per Day 5.47939
Cycle 1 Standard Survey Health Date 11/22/2016
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 01/14/2016
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 Standard Health Deficiencies 1
Cycle 3 Health Deficiency Score 4
Cycle 3 Standard Health Survey Date 12/04/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 4
Total Weighted Health Survey Score 4.667
Number of Fines 1
Total Amount of Fines in Dollars $4800.00
Total Number of Penalties 1
Processing Date 08/01/2017

Owner or Manager · Northwest Florida Community Hospital (snu)

Owner Name Role Association Date
JD-MLS TRUST (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
6%
since 12/21/2012
KRIEGER, SCOTT (Individual) DIRECTOR since 12/21/2012
MARLER, ANNICE (Individual) MANAGING EMPLOYEE since 10/30/2009
SCHLENKER, PATRICK (Individual) DIRECTOR since 03/20/2004
SCHWARTZ, SHARONE (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
6%
since 12/21/2012
SHERRY LATT LOWY GRANDCHILDREN TRUST (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
5%
since 12/21/2012
SMEDRA, IRA (Individual) DIRECTOR since 12/21/2012
SMEDRA, IRA (Individual) OFFICER since 12/21/2012
STEIER, E (Individual) 5% OR GREATER DIRECT OWNERSHIP INTEREST
8%
since 12/21/2012
STEIER, E (Individual) DIRECTOR since 12/21/2012
STIGLER, CHARLES (Individual) DIRECTOR since 12/21/2012
WINTNER, JACOB (Individual) DIRECTOR since 12/21/2012
WINTNER, JACOB (Individual) OFFICER since 12/21/2012

32428 · Nursing Home

Washington Rehabilitation and Nursing Center 879 Usery Road, Chipley, FL 32428

Chipley · Nursing Home

Washington Rehabilitation and Nursing Center 879 Usery Road, Chipley, FL 32428

FL · Nursing Home

Zephyr Haven Health & Rehab Center, Inc 38250 A Ave, Zephyrhills, FL 33542
Health Center At Sinai Residences 21044 95th Avenue South, Boca Raton, FL 33428
Lake Eustis Health and Rehabilitation Center 411 W Woodward Ave, Eustis, FL 32726
Emerald Health Care Center 1655 Se Walton Road, Port Saint Lucie, FL 34952
Adventist Care Centers-courtland, Inc 730 Courtland Street, Orlando, FL 32804
Fountain Manor Health & Rehabilitation Center 390 Ne 135th St, North Miami, FL 33161
Ponce Plaza Nursing & Rehabilitation Center 335 Sw 12 Avenue, Miami, FL 33130
Solaris Senior Living North Naples 10949 Parnu Street, Naples, FL 34109
Terrace of St Cloud, The 3855 Old Canoe Creek Road, Saint Cloud, FL 34769
Cypress Village 4600 Middleton Park Cir E, Jacksonville, FL 32224
Palace At Kendall Nursing and Rehabilitation Cente 11215 Sw 84th Street, Miami, FL 33173
Gulf Shore Care Center 6767 86th Ave N, Pinellas Park, FL 33782
Santa Rosa Health & Rehabilitation Center 5386 Broad St, Milton, FL 32570
Signature Healthcare of Palm Beach 4405 Lakewood Road, Lake Worth, FL 33461
Consulate Health Care of Winter Haven 2701 Lake Alfred Rd, Winter Haven, FL 33881
Victoria Nursing & Rehabilitation Center, Inc. 955 Nw 3rd St, Miami, FL 33128
Avante At St Cloud Inc 1301 Kansas Ave, Saint Cloud, FL 34769
Rehabilitation Center of St Pete 435 42nd Ave S, Saint Petersburg, FL 33705
Haven of Our Lady of Peace 1900 Summit Boulevard, Pensacola, FL 32503
Riviera Palms Rehabilitation Center 926 Haben Blvd, Palmetto, FL 34221
Nursing Center At University Village, The 12250 N 22nd St, Tampa, FL 33612
Heritage Park Rehabilitation and Healthcare 2826 Cleveland Ave, Fort Myers, FL 33901
Metro West Nursing and Rehab Center 5900 Westgate Drive, Orlando, FL 32825
Auburndale Oaks Care and Rehabilitation Center 919 Old Winter Haven Rd, Auburndale, FL 33823
Cross Terrace Rehabilitation Center 1351 San Christopher Dr, Dunedin, FL 34698
Bayview Center 301 S Bay St, Eustis, FL 32726
Royal Oaks Nursing and Rehab Center 2225 Knox Mcrae Dr, Titusville, FL 32780
Rehabilitation and Health Care Center 110 Lodge Terrace Dr, Altoona, FL 32702
Savannah Cove 1301 W Maitland Blvd, Maitland, FL 32751
Regents Park At Aventura 18905 Ne 25th Ave, Aventura, FL 33180
Martin Nursing and Restorative Care Center 6011 Se Tower Dr, Stuart, FL 34997
Sunset Point 1980 Sunset Point Rd, Clearwater, FL 33765
Highland Pines Rehabilitation Center 1111 S Highland Ave, Clearwater, FL 33756
Solaris Healthcare Parkway 800 Se Central Pkwy, Stuart, FL 34994
Island Lake Center 155 Landover Place, Longwood, FL 32750
Mayflower Healthcare Center 1620 Mayflower Court, Winter Park, FL 32792
Ruleme Center 2810 Ruleme St, Eustis, FL 32726
Consulate Health Care of New Port Richey 8417 Old County Rd 54, New Port Richey, FL 34653
Indigo Manor 595 N Williamson Blvd, Daytona Beach, FL 32114
Evans Health Care 3735 Evans Ave, Fort Myers, FL 33901