BENTWOOD NURSING & REHAB

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 6/10/2019 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENNTIFICATION NUMBER: 265757 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED 11/09/2018 NAME OF PROVIDER OF SUPPLIER BENTWOOD NURSING & REHAB STREET ADDRESS, CITY, …

BENTONVIEW PARK HEALTH & REHABILITATION

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 6/10/2019 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENNTIFICATION NUMBER: 265410 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED 07/17/2018 NAME OF PROVIDER OF SUPPLIER BENTONVIEW PARK HEALTH & REHABILITATION STREET ADDRESS, …

BENTLEYS EXTENDED CARE

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 6/10/2019 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENNTIFICATION NUMBER: 265732 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED 01/30/2019 NAME OF PROVIDER OF SUPPLIER BENTLEYS EXTENDED CARE STREET ADDRESS, CITY, STATE, …

BELLEFONTAINE GARDENS NURSING & REHAB

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 6/10/2019 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENNTIFICATION NUMBER: 265709 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED 03/09/2018 NAME OF PROVIDER OF SUPPLIER BELLEFONTAINE GARDENS NURSING & REHAB STREET ADDRESS, …

BEAUVAIS MANOR HEALTHCARE & REHAB CENTER

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 6/10/2019 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENNTIFICATION NUMBER: 265699 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED 01/15/2019 NAME OF PROVIDER OF SUPPLIER BEAUVAIS MANOR HEALTHCARE & REHAB CENTER STREET …

AUTUMN TERRACE HEALTH & REHABILITATION

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 6/10/2019 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENNTIFICATION NUMBER: 265339 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED 12/07/2018 NAME OF PROVIDER OF SUPPLIER AUTUMN TERRACE HEALTH & REHABILITATION STREET ADDRESS, …

ASHTON COURT CARE AND REHABILITATION CENTRE

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 6/10/2019 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENNTIFICATION NUMBER: 265437 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED 09/07/2018 NAME OF PROVIDER OF SUPPLIER ASHTON COURT CARE AND REHABILITATION CENTRE STREET …

APPLETON CITY MANOR

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 6/10/2019 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENNTIFICATION NUMBER: 265843 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED 08/30/2018 NAME OF PROVIDER OF SUPPLIER APPLETON CITY MANOR STREET ADDRESS, CITY, STATE, …

ALEXIAN BROTHERS LANSDOWNE VILLAGE

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 6/5/2019 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENNTIFICATION NUMBER: 265351 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED 08/14/2018 NAME OF PROVIDER OF SUPPLIER ALEXIAN BROTHERS LANSDOWNE VILLAGE STREET ADDRESS, CITY, …

ADRIAN MANOR HEALTH & REHABILITATION CENTER

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 6/5/2019 FORM APPROVED OMB NO. 0938-0391 STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENNTIFICATION NUMBER: 265780 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED 01/17/2019 NAME OF PROVIDER OF SUPPLIER ADRIAN MANOR HEALTH & REHABILITATION CENTER STREET …