Creekwood Place Nursing & Rehab Center, Inc - Russellville Nursing Home
General Information
UPDATEFederal Provider Number
185313
Provider Name
CREEKWOOD PLACE NURSING & REHAB CENTER, INC
Provider Address
107 BOYLES DRIVE
RUSSELLVILLE, KY 42276
RUSSELLVILLE, KY 42276
Provider Phone Number
(270) 726-9049
Provider SSA County
700
Provider County Name
Logan
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
104
Number of Residents in Certified Beds
93
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CREEKWOOD PLACE NURSING & REHAB CENTER, INC.
Date First Approved to Provide Medicare and Medicaid services
1992-01-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
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
2.45000
Reported LPN Staffing Hours per Resident per Day
0.66290
Reported RN Staffing Hours per Resident per Day
0.57043
Reported Licensed Staffing Hours per Resident per Day
1.23333
Reported Total Nurse Staffing Hours per Resident per Day
3.68333
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06667
Expected CNA Staffing Hours per Resident per Day
2.60410
Expected LPN Staffing Hours per Resident per Day
0.70792
Expected RN Staffing Hours per Resident per Day
1.08477
Expected Total Nurse Staffing Hours per Resident per Day
4.39679
Adjusted CNA Staffing Hours per Resident per Day
2.30850
Adjusted LPN Staffing Hours per Resident per Day
0.77721
Adjusted RN Staffing Hours per Resident per Day
0.39292
Adjusted Total Nurse Staffing Hours per Resident per Day
3.37681
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2015-02-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2014-01-31
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
91
Cycle 3 Standard Health Survey Date
2013-04-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
91
Total Weighted Health Survey Score
36.50000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
21200
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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