Meadowood - Grayville Nursing Home
General Information
UPDATEFederal Provider Number
146119
Provider Name
MEADOWOOD
Provider Address
320 SECOND STREET
GRAYVILLE, IL 62844
GRAYVILLE, IL 62844
Provider Phone Number
(618) 375-2171
Provider SSA County
987
Provider County Name
White
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
74
Number of Residents in Certified Beds
44
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BONUM INC
Date First Approved to Provide Medicare and Medicaid services
2007-10-01
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.75795
Reported LPN Staffing Hours per Resident per Day
0.81705
Reported RN Staffing Hours per Resident per Day
0.75341
Reported Licensed Staffing Hours per Resident per Day
1.57045
Reported Total Nurse Staffing Hours per Resident per Day
4.32841
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01136
Expected CNA Staffing Hours per Resident per Day
2.14941
Expected LPN Staffing Hours per Resident per Day
0.57425
Expected RN Staffing Hours per Resident per Day
0.81300
Expected Total Nurse Staffing Hours per Resident per Day
3.53666
Adjusted CNA Staffing Hours per Resident per Day
3.14839
Adjusted LPN Staffing Hours per Resident per Day
1.18093
Adjusted RN Staffing Hours per Resident per Day
0.69244
Adjusted Total Nurse Staffing Hours per Resident per Day
4.93330
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2015-04-02
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
40
Cycle 1 Total Health Score
120
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2014-01-29
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2013-02-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
76.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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