General Information: MOOSEHAVEN
Nursing home name MOOSEHAVEN
Address1701 PARK AVENUE
ORANGE PARK, FL 32073
Phone number (904) 278-1200
Located within a hospital No
Type of ownership Non profit - Corporation
Owner operates multiple homesNo
Accept Medicare or Medicaid Medicare and Medicaid
Continue Care Retirement CommunityYes
Resident and family councils Resident
Certified number of beds 36
Total number of residents 27
Perc of occupied beds 75
Sprinkler status Yes
Number of Facility Reported Incidents0
Number of Substantiated Complaints0
Number of Fines0
Total Amount of Fines$0
Total Number of Penalties0
Total Number of Penalties0
Ratings Summary: MOOSEHAVEN
Overall rating 5
5
Nursing Home Staffing 5
5
Registered Nurses only 5
5
Health Inspections 5
5
Quality Measures 4
4
Nursing Home Staffing Info: MOOSEHAVEN
National AverageFlorida AverageMOOSEHAVEN
Overall staff rating NA NA 5
5
Registered Nurses only rating NANA 5
5
Total Number of Residents NA NA 27
Total Number of Nurse Staff Hours per Resident per Day 4.11 hours 4.46 hours 5.59 hours
Total Number of Licensed Nurse Staff Hours per Resident per Day 1.64 hours 1.67 hours 2.1 hours
Registered Nurses Hours per Residents per Day 0.81 hours 0.71 hours 1.21 hours
Licensed Practical or Vacation Nurses Hours per Resident per Day 0.83 hours 0.96 hours 0.89 hours
Certified Nursing Assistants Hours per Residents per Day 2.47 hours 2.78 hours 3.49 hours
Physical Therapy Staffing Hours per Resident Per Day 0.1 hours 0.13 hours 0.06 hours
Health Survey: MOOSEHAVEN
Heath Survey Summary on 2013-06-20
Total Number of Health Deficiencies 1
Scope and Severity of most Severe Health Deficiency Isolated/Minimal harm or potential for actual harm
Heath Survey Summary on 2012-04-11
Total Number of Health Deficiencies 2
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Heath Survey Summary on 2011-05-05
Total Number of Health Deficiencies 3
Scope and Severity of most Severe Health Deficiency Isolated/Minimal harm or potential for actual harm
Health Survey Details: MOOSEHAVEN
Inspection Results: 06/20/2013
Corrected Deficiency Scope and Severity
07/20/2013 Have a program that investigates, controls and keeps infection from spreading. Isolated/Minimal harm or potential for actual harm
Inspection Results: 04/11/2012
Corrected Deficiency Scope and Severity
05/11/2012 Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Isolated/Minimal harm or potential for actual harm
05/11/2012 Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. Widespread /Minimal harm or potential for actual harm
Inspection Results: 05/05/2011
Corrected Deficiency Scope and Severity
06/05/2011 Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. Isolated/Minimal harm or potential for actual harm
06/05/2011 Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being. Isolated/Minimal harm or potential for actual harm
06/05/2011 Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. Isolated/Minimal harm or potential for actual harm

Fire Safety Survey: MOOSEHAVEN
Fire Safety Survey Summary on 2013-06-19
Total Number of Fire SafetyDeficiencies 6
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Fire Safety Survey Summary on 2012-04-18
Total Number of Fire SafetyDeficiencies 0
Scope and Severity of most Severe Health Deficiency
Fire Safety Survey Summary on 2011-05-03
Total Number of Fire SafetyDeficiencies 1
Scope and Severity of most Severe Health Deficiency Isolated/Minimal harm or potential for actual harm
Fire Safety Survey: MOOSEHAVEN
Fire Safety Survey Results: 06/19/2013
Corrected Deficiency Severity
07/20/2013 At least two compartments on every floor to protect residents from smoke. Widespread /Minimal harm or potential for actual harm
07/20/2013 Properly installed electrical wiring and equipment. Pattern/Minimal harm or potential for actual harm
07/20/2013 Weekly inspections and monthly testing of generators. Widespread /Minimal harm or potential for actual harm
07/20/2013 Rooms that can be unlocked from inside without a key. Widespread /Minimal harm or potential for actual harm
07/20/2013 Record of quarterly fire drills for each shift under varying conditions. Widespread /Minimal harm or potential for actual harm
07/20/2013 Automatic sprinkler systems that have been maintained in working order. Pattern/Minimal harm or potential for actual harm
Fire Safety Survey Results: 05/03/2011
Corrected Deficiency Severity
06/05/2011 Properly protected cooking facilities. Isolated/Minimal harm or potential for actual harm

Resident Complaints: MOOSEHAVEN
Not available

Quality Measures: MOOSEHAVEN
Quality Measures National Average Florida Average MOOSEHAVEN
Overall quality rating NA NA 4
4
Long-Stay Residents
Percent of Long Stay Residents Whose Need for Help with ADLs has Increased 15.4% 13.2% 27.1%
Percent of Long Stay Residents Who Self Report Moderate to Severe Pain 8.3% 5.9% 15.1%
Percent of High Risk Long Stay Residents With Pressure Ulcers 6.1% 6.3% 1.4%
Percent of Long Stay Residents Who Lose Too Much Weight 7.2% 7.9% 13.6%
Percent of Low Risk Long Stay Residents Who Lose Control of Their Bowel or Bladder 43.9% 48.1% %
Percent of Long Stay Residents with a Catheter Inserted and Left in Their Bladder 3.2% 2.8% 0.0%
Percent of Long Stay Residents With a Urinary Tract Infection 6.2% 7.1% 6.8%
Percent of Long Stay Residents Who Have Depressive Symptoms 6.3% 2.7% 10.7%
Percent of Long Stay Residents Who Were Physically Restrained 1.4% 1.9% 3.3%
Percent of Long Stay Residents Experiencing One or More Falls with Major Injury 3.2% 2.6% 1.1%
Percent of Long Stay Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine 92.7% 91.8% 100.0%
Percent of Long Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 94.3% 95.1% 100.0%
Percent of Long Stay Residents Who Received an Antipsychotic Medication 20.7% 21.7% 17.8%
Short-Stay Residents
Percent of Short Stay Residents Who Self Report Moderate to Severe Pain 19.2% 16.7% 11.8%
Percent of Short Stay Residents With Pressure Ulcers That Are New or Worsened 1.2% 0.8% 0.9%
Percent of Short Stay Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine 83.4% 84.8% 98.9%
Percent of Short Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 82.4% 86.6% 99.0%
Percent of Short Stay Residents Who Newly Received an Antipsychotic Medication 2.6% 3.2% 3.3%

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