Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

MOULTRIE CREEK NURSING AND REHAB CENTER

SAINT AUGUSTINE, FL · 120 certified beds · Last Life Safety survey October 3, 2024

CMS Certification Number 105548 · first certified December 1986

Ownership

Operated by SOVEREIGN HEALTHCARE HOLDINGS · For profit - Corporation

No change of ownership on CMS record since January 1, 2016, when the records begin.

3
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
0
Tags cited more than once
Across separate surveys
2
Inspection & testing records
Of the citations on file

Position within FL

3 citations — more than 19% of the 694 certified nursing homes in FL. Compared within FL rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated

When is the next survey likely?

Past the typical window (January 2026 to August 2026). Most FL facilities have been surveyed by November 2026. This facility’s last Life Safety survey was October 2024. Facilities in FL are typically surveyed 15–23 months after the last one (median 17), measured over 729 consecutive surveys in the last two years of CMS records.

A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured

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Which alerts

Physical environment (health survey)

3 physical-environment citations on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 3 Life Safety citations above. The Physical Environment Index

  • F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  • F-0880 Provide and implement an infection prevention and control program.

How that compares

Citations on file over three years

Compared with the median facility in FL, and nationally. Surveyors differ markedly between states, so the FL figure is the meaningful one.

This facility3FL median7National median11
Citations on file over three years, compared
MeasureCitations
This facility3
Median facility in FL7
Median facility nationally11

Survey history

Citations at each Life Safety survey
02021-0402022-1132024-10
Citations at each Life Safety survey
Survey dateCitations
April 1, 20210
November 17, 20220
October 3, 20243

Most-cited tags

Most-cited tags at this facility
K-03451K-09181K-09141
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0345Have approved installation, maintenance and testing program for fire alarm systems.12024-10-03
K-0918Have generator or other power source capable of supplying service within 10 seconds.12024-10-03
K-0914Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.12024-10-03

What the citations cover

Citations by CMS category
  • Gas, Vacuum, and Electrical Systems Deficiencies 2
  • Smoke Deficiencies 1
Citations by CMS category
CategoryCitations
Gas, Vacuum, and Electrical Systems Deficiencies2
Smoke Deficiencies1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

October 3, 2024 — 3 citations

Citations issued on October 3, 2024
TagWhat the surveyor checksStatus
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (November 1, 2024)
K-0914Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.Deficient, Provider has date of correction (November 1, 2024)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (November 1, 2024)

Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.