Covenant Village Of Green Township - Cincinnati Nursing Home

General Information

UPDATE
Federal Provider Number
366399
Provider Name
COVENANT VILLAGE OF GREEN TOWNSHIP
Provider Address
3210 WEST FORK ROAD
CINCINNATI, OH 45211
Provider Phone Number
5136053000
Provider SSA County
310
Provider County Name
Hamilton
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
67
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COVENANT VILLAGE OF GREEN TOWNSHIP LLC
Date First Approved to Provide Medicare and Medicaid services
2012-12-11
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.29403
Reported LPN Staffing Hours per Resident per Day
1.28433
Reported RN Staffing Hours per Resident per Day
1.86045
Reported Licensed Staffing Hours per Resident per Day
3.14478
Reported Total Nurse Staffing Hours per Resident per Day
5.43881
Reported Physical Therapist Staffing Hours per Resident Per Day
0.17612
Expected CNA Staffing Hours per Resident per Day
2.26663
Expected LPN Staffing Hours per Resident per Day
0.74588
Expected RN Staffing Hours per Resident per Day
1.63165
Expected Total Nurse Staffing Hours per Resident per Day
4.64417
Adjusted CNA Staffing Hours per Resident per Day
2.48336
Adjusted LPN Staffing Hours per Resident per Day
1.42917
Adjusted RN Staffing Hours per Resident per Day
0.85198
Adjusted Total Nurse Staffing Hours per Resident per Day
4.72061
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-03-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2012-12-11
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
-0001-11-30
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
12.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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