ST PETERS MANOR CARE CENTER

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 9/25/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265589 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER ST PETERS MANOR CARE CENTER STREET ADDRESS, CITY, STATE, ZIP 230 SPENCER ROADSAINT …

ST LOUIS PLACE HEALTH & REHABILITATION

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 9/25/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265586 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER ST LOUIS PLACE HEALTH & REHABILITATION STREET ADDRESS, CITY, STATE, ZIP 2600 REDMAN …

SPRING VALLEY HEALTH & REHABILITATION CENTER

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 9/25/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265188 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER SPRING VALLEY HEALTH & REHABILITATION CENTER STREET ADDRESS, CITY, STATE, ZIP 2915 SOUTH …

SEVILLE CARE CENTER

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 9/3/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265521 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER SEVILLE CARE CENTER STREET ADDRESS, CITY, STATE, ZIP 35625 HIGHWAY 72, PO BOX …

ROYAL OAK NURSING & REHAB

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 9/3/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265378 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER ROYAL OAK NURSING & REHAB STREET ADDRESS, CITY, STATE, ZIP 4960 LACLEDE AVENUESAINT …

LEGENDARY NURSING & REHABILITATION LLC

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 7/31/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265508 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER LEGENDARY NURSING & REHABILITATION LLC STREET ADDRESS, CITY, STATE, ZIP 809 EAST GORDON …

LEBANON NORTH NURSING & REHAB

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 7/31/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265123 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER LEBANON NORTH NURSING & REHAB STREET ADDRESS, CITY, STATE, ZIP 596 MORTON ROADLEBANON, …

HILLSIDE MANOR HEALTHCARE AND REHAB CENTER

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 7/31/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265585 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED NAME OF PROVIDER OF SUPPLIER HILLSIDE MANOR HEALTHCARE AND REHAB CENTER STREET ADDRESS, CITY, STATE, ZIP 1265 MCLARAN …

GARDEN VIEW CARE CENTER AT DOUGHERTY FERRY

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 7/23/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265808 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED 07/16/2018 NAME OF PROVIDER OF SUPPLIER GARDEN VIEW CARE CENTER AT DOUGHERTY FERRY STREET ADDRESS, CITY, STATE, ZIP …

COUNTRY VIEW NURSING FACILITY, INC

Original Inspection report DEPARTMENT OF HEALTH AND HUMAN SERVICESCENTERS FOR MEDICARE & MEDICAID SERVICES PRINTED: 7/12/2019FORM APPROVEDOMB NO. 0938-0391 STATEMENT OF DEFICIENCIESAND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIAIDENNTIFICATION NUMBER: 265419 (X2) MULTIPLE CONSTRUCTION A. BUILDING ___________ B. WING ___________ (X3) DATE SURVEY COMPLETED 02/14/2019 NAME OF PROVIDER OF SUPPLIER COUNTRY VIEW NURSING FACILITY, INC STREET ADDRESS, CITY, STATE, ZIP 2106 WEST …