DOUGLAS JACOBSON STATE VETERANS NURSING HOME

21281 GRAYTON TERRACE
PORT CHARLOTTE, FL, 33954
9416130919
CCN: 106059
3
Overall
2
Health
5
Staffing
3
Quality
ChainFLORIDA DEPARTMENT OF VETERANS' AFFAIRS
Special FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
NameRole%
FLORIDA DEPARTMENT OF VETERANS AFFAIRS5% OR GREATER DIRECT OWNERSHIP INTEREST100%
CARTER, ALFREDCORPORATE DIRECTORNOT APPLICABLE
GAYLORD, BRANDYOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
MALLARD, LINDSAYOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
WURSTER, JOCEYLYNOPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE
Penalties (6)
DateTypeAmount
2025-06-25Fine$8K
2025-02-11Fine$72K
2024-09-06Fine$16K
2024-09-06Payment Denial34 days
2023-06-02Fine$8K
2023-06-02Payment Denial4 days
Health Deficiencies (20)
2025-08-21 · Health
D
F557 · Resident Rights Deficiencies
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
2025-07-16 · Health
D
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
2025-06-25 · Health
E
F602 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from the wrongful use of the resident's belongings or money.
D
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
2025-02-11 · Health
G
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
2024-10-29 · Health
G
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
G
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
2024-09-06 · Health
D
F726 · Nursing and Physician Services Deficiencies
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
E
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
E
F680 · Quality of Life and Care Deficiencies
Ensure the activities program is directed by a qualified professional.
E
F679 · Quality of Life and Care Deficiencies
Provide activities to meet all resident's needs.
E
F657 · Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
D
F582 · Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
G
F580 · Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
2023-06-02 · Health
D
F740 · Quality of Life and Care Deficiencies
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
D
F725 · Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
G
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
F565 · Resident Rights Deficiencies
Honor the resident's right to organize and participate in resident/family groups in the facility.
2021-10-07 · Health
D
F744 · Quality of Life and Care Deficiencies
Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
D
F700 · Quality of Life and Care Deficiencies
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day
4.62
3.68
RN Hrs/Resident/Day
0.99
0.54
LPN Hrs/Resident/Day
0.88
0.81
CNA Hrs/Resident/Day
2.74
2.33
PT Hrs/Resident/Day
0.05
0.12
Data as of 2026-03-01