Coventry House Inn - St Joseph Nursing Home
General Information
UPDATEFederal Provider Number
235605
Provider Name
COVENTRY HOUSE INN
Provider Address
3905 LORRAINE PATH
ST JOSEPH, MI 49085
ST JOSEPH, MI 49085
Provider Phone Number
2694281111
Provider SSA County
100
Provider County Name
Berrien
Ownership Type
For profit - Corporation
Number of Certified Beds
32
Number of Residents in Certified Beds
26
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
CLIFFSIDE COMPANY LLC
Date First Approved to Provide Medicare and Medicaid services
2003-03-14
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
5
Overall Rating Footnote
Health Inspection Rating
5
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
3.07500
Reported LPN Staffing Hours per Resident per Day
0.87692
Reported RN Staffing Hours per Resident per Day
2.93654
Reported Licensed Staffing Hours per Resident per Day
3.81346
Reported Total Nurse Staffing Hours per Resident per Day
6.88846
Reported Physical Therapist Staffing Hours per Resident Per Day
0.39038
Expected CNA Staffing Hours per Resident per Day
2.21532
Expected LPN Staffing Hours per Resident per Day
0.62514
Expected RN Staffing Hours per Resident per Day
1.43211
Expected Total Nurse Staffing Hours per Resident per Day
4.27257
Adjusted CNA Staffing Hours per Resident per Day
3.40589
Adjusted LPN Staffing Hours per Resident per Day
1.16428
Adjusted RN Staffing Hours per Resident per Day
1.53214
Adjusted Total Nurse Staffing Hours per Resident per Day
6.49883
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-05-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-06-28
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
5
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-08-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
16.66700
Number of Facility Reported Incidents
1
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
Nursiong Homes Nearby
Royalton Manor, L L C
288 Peace Blvd |
ST JOSEPH MI 49085 | 0.3 mile away
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