Shoal Creek Rehabilitation Center

MEDICARE CERTIFIED

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Shoal Creek Rehabilitation Center was recognized and ceritified in 2000 by Centers for Medicare & Medicaid Services as one of model nursing home providers promoting health and improving quality of life. Shoal Creek Rehabilitation Center which is located in 500 Hospital Drive Crestview, is scientifically measured and assessed by Centers for Medicare & Medicaid Services and is shown to provide good nursing home services or products under the Medicare program. Shoal Creek Rehabilitation Center is being offered ceritified services and products in Florida.

  500 Hospital Drive
       Crestview, FL 32539

  (850) 689-3146

County: Okaloosa
Federal Provider Number: 106028

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Participates in: Medicare And Medicaid
Certified Date: Thursday, April 27, 2000 (24 years certified)
Certified Agency: Centers for Medicare & Medicaid Services
Legal Business Name: 500 South Hospital Drive Operation Llc
Ownership Type: For Profit - Corporation
Provider Changed Ownership in Last 12 Months: No

Type	Name	Role Description
Organization	Lavie Care Centers, Llc	5% Or More Ownership Interest
Organization	Genoa Healthcare Group Llc	5% Or More Ownership Interest
Organization	General Electric Capital Corporation	5% Or Greater Security Interest
Organization	Florida Health Care Properties Llc	5% Or More Ownership Interest
Organization	Fc Investors Xxi, Llc	5% Or More Ownership Interest
Organization	Epsilon Health Care Properties Llc	5% Or More Ownership Interest
Organization	David Reis Sub S Trust	5% Or More Ownership Interest
Organization	Columbia Pacific Opportunity Fund L.p.	5% Or More Ownership Interest
Organization	Alg Lavie, Llc	5% Or More Ownership Interest
Organization	Lv Investment, Llc	5% Or More Ownership Interest
Organization	Lv Operations I, Llc	5% Or More Ownership Interest
Organization	Lv Operations Ii, Llc	5% Or More Ownership Interest
Organization	Mcp Lavie, Llc	5% Or More Ownership Interest
Organization	Say La Vie, Llc	5% Or More Ownership Interest
Organization	Sea Crest Health Care Management Llc	Operational/managerial Control
Organization	Senior Care Lavie, Llc	5% Or More Ownership Interest
Organization	The 1995 David Reis Family Trust	5% Or More Ownership Interest
Person	Zvi Tress	Director/officer
Person	Harold Sussman	Director/officer
Person	David Reis	Director/officer
Person	Isaac Neuberger	Director/officer
Person	Isaac Neuberger	5% Or More Ownership Interest
Person	Asher Low	Director/officer
Person	Asher Low	5% Or More Ownership Interest
Person	Jeffrey Jellerson	Director/officer
Person	Robert Hartman	Director/officer
Person	Robert Hartman	5% Or More Ownership Interest
Person	Steven Fishman	Director/officer
Person	Christina Firth	Director/officer
Person	Joseph Conte	Director/officer
Person	Troy Antonik	Director/officer
Person	Dana Alcorn	W-2 Managing Employee
Person	Dana Alcorn	Director/officer

Provider Resides in Hospital: No
Number of Federally Certified Beds: 120
Number of Residents in Federally Certified Beds: 116 (97% occupied)
Continuing Care Retirement Community: No
Special Focus Facility: No
With a Resident and Family Council: Resident
Automatic Sprinkler Systems in All Required Areas: Yes

Survey Date: Thursday, July 31, 2014
Survey Type: Health
Deficiency: F0371 (Store, cook, and serve food in a safe and clean way.)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Sunday, August 31, 2014
The inspection cycle of deficiency: 1 (the deficiency was found on a standard inspection)

Survey Date: Wednesday, July 30, 2014
Survey Type: Fire Safety
Deficiency: K0076 (Proper medical gas storage and administration areas.)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Sunday, August 31, 2014
The inspection cycle of deficiency: 1 (the deficiency was found on a standard inspection)

Survey Date: Wednesday, July 30, 2014
Survey Type: Fire Safety
Deficiency: K0046 (Emergency lighting that can last at least 1 1/2 hours.)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Sunday, August 31, 2014
The inspection cycle of deficiency: 1 (the deficiency was found on a standard inspection)

Survey Date: Wednesday, July 30, 2014
Survey Type: Fire Safety
Deficiency: K0052 (An approved installation, maintenance and testing program for fire alarm systems.)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Sunday, August 31, 2014
The inspection cycle of deficiency: 1 (the deficiency was found on a standard inspection)

Survey Date: Thursday, May 23, 2013
Survey Type: Health
Deficiency: F0371 (Store, cook, and serve food in a safe and clean way.)
Scope Severity Code: F
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Sunday, June 23, 2013
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Thursday, May 23, 2013
Survey Type: Health
Deficiency: F0242 (Ensure residents have the right to have a choice over activities, their schedules, and health care a)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Sunday, June 23, 2013
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Wednesday, May 22, 2013
Survey Type: Fire Safety
Deficiency: K0052 (An approved installation, maintenance and testing program for fire alarm systems.)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Sunday, June 23, 2013
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Thursday, March 1, 2012
Survey Type: Health
Deficiency: F0371 (Store, cook, and serve food in a safe and clean way.)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Friday, April 13, 2012
The inspection cycle of deficiency: 3 (the deficiency was found on a standard inspection)

Survey Date: Thursday, March 1, 2012
Survey Type: Health
Deficiency: F0309 (Provide necessary care and services to maintain or improve the highest well being of each resident .)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Friday, April 13, 2012
The inspection cycle of deficiency: 3 (the deficiency was found on a standard inspection)

Survey Date: Thursday, March 1, 2012
Survey Type: Health
Deficiency: F0312 (Assist those residents who need help with eating/drinking, grooming and personal and oral hygiene.)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Friday, April 13, 2012
The inspection cycle of deficiency: 3 (the deficiency was found on a standard inspection)

Survey Date: Thursday, March 1, 2012
Survey Type: Health
Deficiency: F0353 (Have enough nurses to care for every resident in a way that maximizes the resident's well being.)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Friday, April 13, 2012
The inspection cycle of deficiency: 3 (the deficiency was found on a standard inspection)

Survey Date: Wednesday, February 29, 2012
Survey Type: Fire Safety
Deficiency: K0067 (Heating and ventilation systems that have been properly installed according to the manufacturer's in)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Tuesday, April 24, 2012
The inspection cycle of deficiency: 3 (the deficiency was found on a standard inspection)

Survey Date: Wednesday, February 29, 2012
Survey Type: Fire Safety
Deficiency: K0130 (Other fire safety features required by fire safety codes.)
Scope Severity Code: F
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Tuesday, April 24, 2012
The inspection cycle of deficiency: 3 (the deficiency was found on a standard inspection)

Number of Facility Reported Incidents: 0
Number of Substantiated Complaints: 0
Number of Fines: 0
Number of Payment Denials: 0
Total Number of Penalties: 0
Total Amount of Fines in Dollars: USD 0

This data allows consumers to compare information about nursing homes. Information here is not an endorsement or advertisement for any nursing home and should be considered carefully. Use it with other information you gather about nursing homes facilities. Talk to your doctor or other health care provider about this.

This data was updated by using data source from Centers for Medicare and Medicaid Services (CMS) which is publicized on Wednesday, October 1, 2014. If you found out that something incorrect and want to change it, please follow this Update Data guide.

The Five Star Quality Rating System is not a substitute for visiting the nursing home. This system can give you important information, help you compare nursing homes by topics you consider most important, and help you think of questions to ask when you visit the nursing home. Use the Five-Star ratings together with other sources of information.

items	rating
Health Inspection Rating	(5 out of 5 stars)
Quality Rating	(4 out of 5 stars)
Staffing Rating	(4 out of 5 stars)
RN Staffing Rating	(3 out of 5 stars)
Overall Rating	(5 out of 5 stars)

Nursing homes vary in the quality of care and services they provide to their residents. Reviewing health inspection results, staffing data, and quality measure data are three important ways to measure nursing home quality. This information gives you a "snap shot" of the care individual nursing home give.

Patients experiences	Provider	State	Nation
Percent of High Risk Long Stay Residents With Pressure Ulcers	N/A	6%	6%
Percent of Long Stay Residents Experiencing One or More Falls with Major Injury	N/A	3%	3%
Percent of Long Stay Residents Who Self Report Moderate to Severe Pain	N/A	5%	8%
Percent of Long Stay Residents Who Were Physically Restrained	N/A	2%	1%
Percent of Long Stay Residents Whose Need for Help with ADLs has Increased	N/A	13%	16%
Percent of Long Stay Residents with a Catheter Inserted and Left in Their Bladder	N/A	3%	3%
Percent of Long Stay Residents With a Urinary Tract Infection	N/A	6%	6%
Percent of Short Stay Residents Who Self Report Moderate to Severe Pain	N/A	16%	19%
Percent of Short Stay Residents With Pressure Ulcers That Are New or Worsened	N/A	1%	1%
Percent of Long Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine	N/A	95%	94%
Percent of Long Stay Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine	N/A	93%	94%
Percent of Long Stay Residents Who Have Depressive Symptoms	N/A	2%	6%
Percent of Long Stay Residents Who Lose Too Much Weight	N/A	8%	7%
Percent of Long Stay Residents Who Received an Antipsychotic Medication	N/A	21%	20%
Percent of Low Risk Long Stay Residents Who Lose Control of Their Bowel or Bladder	N/A	49%	44%
Percent of Short Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine	N/A	87%	83%
Percent of Short Stay Residents Who Newly Received an Antipsychotic Medication	N/A	3%	2%
Percent of Short Stay Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine	N/A	86%	84%

N/A

Data not available.

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Shoal Creek Rehabilitation Center [Federal No:106028] near 500 Hospital Drive, Crestview FL

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