Covenant Village Care Center - Plantation Nursing Home
General Information
UPDATEFederal Provider Number
105604
Provider Name
COVENANT VILLAGE CARE CENTER
Provider Address
9211 W BROWARD BLVD
PLANTATION, FL 33324
PLANTATION, FL 33324
Provider Phone Number
(954) 370-8982
Provider SSA County
50
Provider County Name
Broward
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
60
Number of Residents in Certified Beds
47
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COVENANT VILLAGE OF FLORIDA, INC.
Date First Approved to Provide Medicare and Medicaid services
1988-03-15
Continuing Care Retirement Community
Y
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
3.09043
Reported LPN Staffing Hours per Resident per Day
1.05851
Reported RN Staffing Hours per Resident per Day
0.69255
Reported Licensed Staffing Hours per Resident per Day
1.75106
Reported Total Nurse Staffing Hours per Resident per Day
4.84149
Reported Physical Therapist Staffing Hours per Resident Per Day
0.22979
Expected CNA Staffing Hours per Resident per Day
2.74141
Expected LPN Staffing Hours per Resident per Day
0.66506
Expected RN Staffing Hours per Resident per Day
1.07224
Expected Total Nurse Staffing Hours per Resident per Day
4.47871
Adjusted CNA Staffing Hours per Resident per Day
2.76609
Adjusted LPN Staffing Hours per Resident per Day
1.32102
Adjusted RN Staffing Hours per Resident per Day
0.48261
Adjusted Total Nurse Staffing Hours per Resident per Day
4.35741
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-09-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-09-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2012-08-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
54.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
5813
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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