Cedar Ridge Health Rehab Center - Lebanon Nursing Home
General Information
UPDATEFederal Provider Number
145571
Provider Name
CEDAR RIDGE HEALTH REHAB CENTER
Provider Address
ONE PERRYMAN STREET
LEBANON, IL 62254
LEBANON, IL 62254
Provider Phone Number
(618) 537-6165
Provider SSA County
900
Provider County Name
St. Clair
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
116
Number of Residents in Certified Beds
100
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COVENANT CARE MIDWEST, INC.
Date First Approved to Provide Medicare and Medicaid services
1987-07-06
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
4
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
2.21450
Reported LPN Staffing Hours per Resident per Day
0.54100
Reported RN Staffing Hours per Resident per Day
0.69100
Reported Licensed Staffing Hours per Resident per Day
1.23200
Reported Total Nurse Staffing Hours per Resident per Day
3.44650
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01150
Expected CNA Staffing Hours per Resident per Day
2.38423
Expected LPN Staffing Hours per Resident per Day
0.60499
Expected RN Staffing Hours per Resident per Day
1.07288
Expected Total Nurse Staffing Hours per Resident per Day
4.06211
Adjusted CNA Staffing Hours per Resident per Day
2.27902
Adjusted LPN Staffing Hours per Resident per Day
0.74221
Adjusted RN Staffing Hours per Resident per Day
0.48124
Adjusted Total Nurse Staffing Hours per Resident per Day
3.42002
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
9
Cycle 1 Health Deficiency Score
234
Cycle 1 Standard Survey Health Date
2015-01-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
234
Cycle 2 Total Number of Health Deficiencies
18
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
10
Cycle 2 Health Deficiency Score
112
Cycle 2 Standard Health Survey Date
2014-02-26
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
112
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2013-03-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
161.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
19
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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