01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2024-09-06 | 6 | 2024-09-06 | 3 |
| Cycle 2 | 2023-06-02 | 12 | 2023-06-02 | 7 |
| Cycle 3 | 2021-10-07 | 2 | 2021-10-07 | 3 |
CMS CCN 1060592026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Douglas Jacobson State Veterans Nursing Home
21281 Grayton Terrace · Port Charlotte, FL 33954 · Charlotte County
Certified beds120CMS provider file
Recent citation rows33current CMS citation release
Penalty rows8current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
33 rows in the current release
5 rows carry G–L scope/severity codes; 0 carry J–L. 3 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-08-21 · HEALTHF0557Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
Correction field: Deficient, Provider has date of correction · 2025-09-21 · complaint2025-07-16 · HEALTHF0600Severity D · isolated; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2025-08-16 · complaint2025-06-25 · HEALTHF0600Severity D · isolated; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2025-08-16 · complaint2025-06-25 · HEALTHF0602Severity E · pattern; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from the wrongful use of the resident's belongings or money.
Correction field: Deficient, Provider has date of correction · 2025-08-16 · complaint2025-02-11 · HEALTHF0600Severity G · isolated actual harm
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.
Correction field: Deficient, Provider has date of correction · 2025-03-11 · complaint2024-10-29 · HEALTHF0600Severity G · isolated actual harm
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.
Correction field: Deficient, Provider has date of correction · 2024-11-25 · complaint2024-10-29 · HEALTHF0689Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2024-11-25 · complaint2024-09-06 · HEALTHF0580Severity G · isolated actual harm
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.
Correction field: Deficient, Provider has date of correction · 2024-11-06 · complaint2024-09-06 · HEALTHF0582Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Correction field: Deficient, Provider has date of correction · 2024-11-062024-09-06 · HEALTHF0657Severity E · pattern; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2024-11-062024-09-06 · HEALTHF0679Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide activities to meet all resident's needs.
Correction field: Deficient, Provider has date of correction · 2024-11-062024-09-06 · HEALTHF0680Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure the activities program is directed by a qualified professional.
Correction field: Deficient, Provider has date of correction · 2024-11-062024-09-06 · HEALTHF0689Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2024-11-06 · complaint2024-09-06 · HEALTHF0726Severity D · isolated; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2024-11-06 · complaint2024-09-06 · FIREK0291Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Install emergency lighting that can last at least 1 1/2 hours.
Correction field: Deficient, Provider has date of correction · 2024-10-062024-09-06 · FIREK0324Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2024-10-062024-09-06 · FIREK0761Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Correction field: Deficient, Provider has date of correction · 2024-10-062023-06-02 · FIREE0004Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Develop and maintain an Emergency Preparedness Program (EP).
Correction field: Deficient, Provider has date of correction · 2023-08-302023-06-02 · FIREE0030Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
List the names and contact information of those in the facility.
Correction field: Deficient, Provider has date of correction · 2023-07-022023-06-02 · FIREE0031Severity D · isolated; potential for more than minimal harm
Emergency Preparedness Deficiencies
Provide emergency officials' contact information.
Correction field: Deficient, Provider has date of correction · 2023-07-022023-06-02 · HEALTHF0565Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to organize and participate in resident/family groups in the facility.
Correction field: Deficient, Provider has date of correction · 2023-07-022023-06-02 · HEALTHF0689Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2023-07-022023-06-02 · HEALTHF0725Severity D · isolated; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2023-07-022023-06-02 · HEALTHF0740Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
Correction field: Deficient, Provider has date of correction · 2023-07-0203 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2025-06-25 | Fine | $7,660 | 0 |
| 2025-06-25 | Fine | $8,490 | 0 |
| 2025-06-25 | Fine | $18,425 | 0 |
| 2025-02-11 | Fine | $46,937 | 0 |
| 2024-09-06 | Fine | $5,346 | 0 |
| 2024-09-06 | Fine | $11,333 | 0 |
| 2024-09-06 | Fine | $15,971 | 0 |
| 2024-09-06 | Payment Denial | $0 | 34 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- CARTER, ALFREDIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 11/28/2011
- GAYLORD, BRANDYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/01/2023
- MALLARD, LINDSAYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/18/2016
- WURSTER, JOCEYLYNIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/18/2022
- WILLIAMS, KEITHIndividual · ADP OF THE SNFNOT APPLICABLE · since 04/08/2025
- WURSTER, JOCEYLYNIndividual · ADP OF THE SNFNOT APPLICABLE · since 04/08/2025
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours4.67per resident day
RN hours1.16per resident day
Weekend nurse hours3.95per resident day
Staff turnover52.1%CMS reported field
06 / LOCAL RECORDS
Open the Port Charlotte ledger →Other published facilities nearby
Charlotte Bay Rehab And Care Center164 beds · CMS overall 1/530 citation rowsHarbour Health Center104 beds · CMS overall 5/529 citation rowsPort Charlotte Rehabilitation Center152 beds · CMS overall 1/533 citation rowsSolaris Healthcare Charlotte Harbor180 beds · CMS overall 4/519 citation rowsSun Harbor Healthcare120 beds · CMS overall 4/517 citation rowsVillage Place Healthcare And Rehabilitation Center104 beds · CMS overall 2/531 citation rows