Edwardsville Nursing & Rehabilitation Center - Edwardsville Nursing Home
General Information
UPDATEFederal Provider Number
145555
Provider Name
EDWARDSVILLE NURSING & REHABILITATION CENTER
Provider Address
401 ST MARY DRIVE
EDWARDSVILLE, IL 62025
EDWARDSVILLE, IL 62025
Provider Phone Number
(618) 692-1330
Provider SSA County
680
Provider County Name
Madison
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
96
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ST. MARY'S HEALTHCARE CTR. INVESTORS, LLC
Date First Approved to Provide Medicare and Medicaid services
1986-06-20
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
1
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.68958
Reported LPN Staffing Hours per Resident per Day
0.82813
Reported RN Staffing Hours per Resident per Day
0.43698
Reported Licensed Staffing Hours per Resident per Day
1.26510
Reported Total Nurse Staffing Hours per Resident per Day
2.95469
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05938
Expected CNA Staffing Hours per Resident per Day
2.42405
Expected LPN Staffing Hours per Resident per Day
0.73409
Expected RN Staffing Hours per Resident per Day
1.29590
Expected Total Nurse Staffing Hours per Resident per Day
4.45403
Adjusted CNA Staffing Hours per Resident per Day
1.71025
Adjusted LPN Staffing Hours per Resident per Day
0.93633
Adjusted RN Staffing Hours per Resident per Day
0.25196
Adjusted Total Nurse Staffing Hours per Resident per Day
2.67399
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2015-02-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2014-03-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
52
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2013-04-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
40.00000
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
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