Covenant Village Of The Great Lakes - Grand Rapids Nursing Home
General Information
UPDATEFederal Provider Number
235614
Provider Name
COVENANT VILLAGE OF THE GREAT LAKES
Provider Address
2520 LAKE MICHIGAN DRIVE NW
GRAND RAPIDS, MI 49504
GRAND RAPIDS, MI 49504
Provider Phone Number
(616) 735-6050
Provider SSA County
400
Provider County Name
Kent
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
37
Number of Residents in Certified Beds
22
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
COVENANT RETIREMENT COMMUNITIES OF THE GREAT LAKES CONFERENCE
Date First Approved to Provide Medicare and Medicaid services
2004-10-28
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
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
3.24545
Reported LPN Staffing Hours per Resident per Day
0.06136
Reported RN Staffing Hours per Resident per Day
1.97955
Reported Licensed Staffing Hours per Resident per Day
2.04091
Reported Total Nurse Staffing Hours per Resident per Day
5.28636
Reported Physical Therapist Staffing Hours per Resident Per Day
0.46364
Expected CNA Staffing Hours per Resident per Day
2.66388
Expected LPN Staffing Hours per Resident per Day
0.65413
Expected RN Staffing Hours per Resident per Day
1.35938
Expected Total Nurse Staffing Hours per Resident per Day
4.67739
Adjusted CNA Staffing Hours per Resident per Day
2.98939
Adjusted LPN Staffing Hours per Resident per Day
0.07786
Adjusted RN Staffing Hours per Resident per Day
1.08808
Adjusted Total Nurse Staffing Hours per Resident per Day
4.55570
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-06-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-06-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-07-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
37.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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