Eden Village Care Center - Glen Carbon Nursing Home

General Information

UPDATE
Federal Provider Number
145384
Provider Name
EDEN VILLAGE CARE CENTER
Provider Address
400 SOUTH STATION ROAD
GLEN CARBON, IL 62034
Provider Phone Number
6182885014
Provider SSA County
680
Provider County Name
Madison
Ownership Type
Non profit - Corporation
Number of Certified Beds
128
Number of Residents in Certified Beds
107
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EDEN RETIREMENT CENTER, INC.
Date First Approved to Provide Medicare and Medicaid services
1979-05-11
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
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.91869
Reported LPN Staffing Hours per Resident per Day
0.75748
Reported RN Staffing Hours per Resident per Day
0.44439
Reported Licensed Staffing Hours per Resident per Day
1.20187
Reported Total Nurse Staffing Hours per Resident per Day
4.12056
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04720
Expected CNA Staffing Hours per Resident per Day
2.24445
Expected LPN Staffing Hours per Resident per Day
0.57469
Expected RN Staffing Hours per Resident per Day
0.95533
Expected Total Nurse Staffing Hours per Resident per Day
3.77447
Adjusted CNA Staffing Hours per Resident per Day
3.19079
Adjusted LPN Staffing Hours per Resident per Day
1.09400
Adjusted RN Staffing Hours per Resident per Day
0.34758
Adjusted Total Nurse Staffing Hours per Resident per Day
4.40051
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2015-02-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-12-13
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
10
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
92
Cycle 3 Standard Health Survey Date
2013-01-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
92
Total Weighted Health Survey Score
46.00000
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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