Coventry Skilled Nursing and Rehabilitation
10 Woodland Drive, Coventry, RI 02816


Coventry Skilled Nursing and Rehabilitation is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 415078. The address is 10 Woodland Drive, Coventry, RI 02816. The zip code is 02816. The phone number is 4018262000.


Coventry Skilled Nursing and Rehabilitation · 10 Woodland Drive, Coventry, RI 02816

Federal Provider Number 415078
Provider Name COVENTRY SKILLED NURSING AND REHABILITATION
Address 10 WOODLAND DRIVE
COVENTRY, RI 02816
Phone Number 4018262000
SSA County Code 10
County Name Kent
Ownership Type For profit - Corporation
Certified Beds 210
Certified Beds Residents 177
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name 10 WOODLAND DRIVE OPERATIONS LLC
Date First Approved to Provide Medicare Medicaid Services 02/08/1983
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Both
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 4
Health Inspection Rating 3
Quality Measure Rating 3
Staffing Rating 4
RN Staffing Rating 4
Reported CNA Staffing Hours per Resident per Day 2.28559
Reported LPN Staffing Hours per Resident per Day 0.63814
Reported RN Staffing Hours per Resident per Day 0.93051
Reported Licensed Staffing Hours per Resident per Day 1.56864
Reported Total Nurse Staffing Hours per Resident per Day 3.85424
Reported Physical Therapist Staffing Hours per Resident Per Day 0.10311
Expected CNA Staffing Hours per Resident per Day 2.35136
Expected LPN Staffing Hours per Resident per Day 0.68844
Expected RN Staffing Hours per Resident per Day 1.11349
Expected Total Nurse Staffing Hours per Resident per Day 4.15329
Adjusted CNA Staffing Hours per Resident per Day 2.38507
Adjusted LPN Staffing Hours per Resident per Day 0.76936
Adjusted RN Staffing Hours per Resident per Day 0.62441
Adjusted Total Nurse Staffing Hours per Resident per Day 3.74066
Cycle 1 Total Number of Health Deficiencies 1
Cycle 1 Number of Standard Health Deficiencies 1
Cycle 1 Health Deficiency Score 8
Cycle 1 Standard Survey Health Date 12/16/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 8
Cycle 2 Total Number of Health Deficiencies 3
Cycle 2 Number of Standard Health Deficiencies 3
Cycle 2 Health Deficiency Score 4
Cycle 2 Standard Health Survey Date 01/11/2016
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 4
Cycle 3 Standard Health Survey Date 10/21/2014
Total Weighted Health Survey Score 5.333
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Coventry Skilled Nursing and Rehabilitation

Owner Name Role Association Date
10 WOODLAND DRIVE OPERATIONS LLC (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 08/14/2008
BERG, MICHAEL (Individual) OFFICER since 12/01/2012
BERG, MICHAEL (Individual) OPERATIONAL/MANAGERIAL CONTROL since 12/01/2012
DAVIS, KEITH (Individual) MANAGING EMPLOYEE since 03/02/2015
DAVIS, KEITH (Individual) OPERATIONAL/MANAGERIAL CONTROL since 12/01/2012
DONNA REIS 1995 FAM TR (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012
EDWARDS, JAN (Individual) OFFICER since 03/02/2015
FC-GEN OPERATIONS INVESTMENT LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012
FISHMAN, STEVEN (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012
GEN OPERATIONS I LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012
GEN OPERATIONS II, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012
GENESIS HEALTHCARE INC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
GENESIS HEALTHCARE LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012
GENESIS HEALTHCARE LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 12/01/2012
GENESIS HOLDINGS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
GENESIS OMG OPERATIONS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012
GHC HOLDINGS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012
HCCF MANAGEMENT GROUP XI LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012
LABATE, WENDY (Individual) OFFICER since 03/02/2015
ONEX PARTNERS LP (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
SENIOR CARE GENESIS LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012
SENIOR CARE HOLDINGS, LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012
SHERMAN, MICHAEL (Individual) OFFICER since 12/01/2012
SHERMAN, MICHAEL (Individual) OPERATIONAL/MANAGERIAL CONTROL since 12/01/2012
SLOTNICK, BARRY (Individual) MANAGING EMPLOYEE since 06/13/2008
SUN HEALTHCARE GROUP, INC. (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 02/02/2015
WHITMAN, ARNOLD (Individual) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012
ZAC PROPERTIES XI LLC (Organization) 5% OR GREATER INDIRECT OWNERSHIP INTEREST
NO PERCENTAGE PROVIDED
since 12/01/2012

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