Providence Pavilion - Covington Nursing Home
General Information
UPDATEFederal Provider Number
185038
Provider Name
PROVIDENCE PAVILION
Provider Address
401 EAST 20TH STREET
COVINGTON, KY 41014
COVINGTON, KY 41014
Provider Phone Number
(859) 283-6600
Provider SSA County
580
Provider County Name
Kenton
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
82
Number of Residents in Certified Beds
73
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PH PROVIDENCE LLC
Date First Approved to Provide Medicare and Medicaid services
1967-02-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
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
2.24863
Reported LPN Staffing Hours per Resident per Day
0.88288
Reported RN Staffing Hours per Resident per Day
0.69795
Reported Licensed Staffing Hours per Resident per Day
1.58082
Reported Total Nurse Staffing Hours per Resident per Day
3.82946
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08836
Expected CNA Staffing Hours per Resident per Day
2.59833
Expected LPN Staffing Hours per Resident per Day
0.71997
Expected RN Staffing Hours per Resident per Day
1.08649
Expected Total Nurse Staffing Hours per Resident per Day
4.40478
Adjusted CNA Staffing Hours per Resident per Day
2.12347
Adjusted LPN Staffing Hours per Resident per Day
1.01781
Adjusted RN Staffing Hours per Resident per Day
0.48000
Adjusted Total Nurse Staffing Hours per Resident per Day
3.50441
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-08-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-08-22
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
8
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-10-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
20.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
2
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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