Integrity Hc Of Godfrey - Godfrey Nursing Home
General Information
UPDATEFederal Provider Number
145656
Provider Name
INTEGRITY HC OF GODFREY
Provider Address
1623 29 WEST DELMAR
GODFREY, IL 62035
GODFREY, IL 62035
Provider Phone Number
6184660443
Provider SSA County
680
Provider County Name
Madison
Ownership Type
For profit - Corporation
Number of Certified Beds
68
Number of Residents in Certified Beds
52
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SA-ENC BLU FOUNTAIN, LLC
Date First Approved to Provide Medicare and Medicaid services
1989-10-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.30096
Reported LPN Staffing Hours per Resident per Day
0.74038
Reported RN Staffing Hours per Resident per Day
0.67596
Reported Licensed Staffing Hours per Resident per Day
1.41635
Reported Total Nurse Staffing Hours per Resident per Day
3.71730
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01346
Expected CNA Staffing Hours per Resident per Day
2.65592
Expected LPN Staffing Hours per Resident per Day
0.69283
Expected RN Staffing Hours per Resident per Day
1.19786
Expected Total Nurse Staffing Hours per Resident per Day
4.54661
Adjusted CNA Staffing Hours per Resident per Day
2.12576
Adjusted LPN Staffing Hours per Resident per Day
0.88697
Adjusted RN Staffing Hours per Resident per Day
0.42165
Adjusted Total Nurse Staffing Hours per Resident per Day
3.29566
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-10-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
23
Cycle 2 Number of Standard Health Deficiencies
20
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
306
Cycle 2 Standard Health Survey Date
2013-11-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-09-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
122.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
Number of Fines
1
Total Amount of Fines in Dollars
20833
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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