General Information: CAMPBELLSVILLE NURSING AND REHABILITATION CENTER
Nursing home name CAMPBELLSVILLE NURSING AND REHABILITATION CENTER
Address1980 OLD GREENSBURG ROAD
CAMPBELLSVILLE, KY 42718
Phone number (270) 465-3506
Located within a hospital No
Type of ownership For profit - Partnership
Owner operates multiple homesYes
Accept Medicare or Medicaid Medicare and Medicaid
Continue Care Retirement CommunityNo
Resident and family councils Resident
Certified number of beds 67
Total number of residents 66
Perc of occupied beds 98
Sprinkler status Yes
Number of Facility Reported Incidents0
Number of Substantiated Complaints1
Number of Fines0
Total Amount of Fines$0
Total Number of Penalties0
Total Number of Penalties0
Ratings Summary: CAMPBELLSVILLE NURSING AND REHABILITATION CENTER
Overall rating 3
3
Nursing Home Staffing 1
1
Registered Nurses only 2
2
Health Inspections 4
4
Quality Measures 4
4
Nursing Home Staffing Info: CAMPBELLSVILLE NURSING AND REHABILITATION CENTER
National AverageKentucky AverageCAMPBELLSVILLE NURSING AND REHABILITATION CENTER
Overall staff rating NA NA 1
1
Registered Nurses only rating NANA 2
2
Total Number of Residents NA NA 66
Total Number of Nurse Staff Hours per Resident per Day 4.11 hours 4.38 hours 3.6 hours
Total Number of Licensed Nurse Staff Hours per Resident per Day 1.64 hours 1.85 hours 1.51 hours
Registered Nurses Hours per Residents per Day 0.81 hours 0.89 hours 0.58 hours
Licensed Practical or Vacation Nurses Hours per Resident per Day 0.83 hours 0.96 hours 0.93 hours
Certified Nursing Assistants Hours per Residents per Day 2.47 hours 2.53 hours 2.09 hours
Physical Therapy Staffing Hours per Resident Per Day 0.1 hours 0.09 hours 0.01 hours
Health Survey: CAMPBELLSVILLE NURSING AND REHABILITATION CENTER
Heath Survey Summary on 2013-06-13
Total Number of Health Deficiencies 3
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Heath Survey Summary on 2012-03-29
Total Number of Health Deficiencies 0
Scope and Severity of most Severe Health Deficiency
Heath Survey Summary on 2011-03-24
Total Number of Health Deficiencies 8
Scope and Severity of most Severe Health Deficiency Pattern/Minimal harm or potential for actual harm
Health Survey Details: CAMPBELLSVILLE NURSING AND REHABILITATION CENTER
Inspection Results: 06/13/2013
Corrected Deficiency Scope and Severity
07/26/2013 Ensure that each resident who enters the nursing home without a catheter is not given a catheter, unless medically necessary, and that incontinent patients receive proper services to prevent urinary tract infections and restore normal bladder functions. Isolated/Minimal harm or potential for actual harm
07/26/2013 Offer other nutritional food to each resident who will not eat the food served. Pattern/Minimal harm or potential for actual harm
07/26/2013 Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. Pattern/Minimal harm or potential for actual harm
Inspection Results: 03/24/2011
Corrected Deficiency Scope and Severity
05/08/2011 Ensure services provided by the nursing facility meet professional standards of quality. Isolated/Minimal harm or potential for actual harm
05/21/2011 Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents. Isolated/Minimal harm or potential for actual harm
05/21/2011 Prepare food that is nutritional, appetizing, tasty, attractive, well-cooked, and at the right temperature. Pattern/Minimal harm or potential for actual harm
05/08/2011 Provide housekeeping and maintenance services. Pattern/Minimal harm or potential for actual harm
05/08/2011 Develop and implement policies for 1) screening and training employees; and the 2) prevention, identification, investigation, and reporting of any abuse, neglect, mistreatment and misappropriation of property. Isolated/Minimal harm or potential for actual harm
05/08/2011 Make sure that special or therapeutic diets are ordered by the attending doctor. Isolated/Minimal harm or potential for actual harm
05/21/2011 Have a program that investigates, controls and keeps infection from spreading. Isolated/Minimal harm or potential for actual harm
05/08/2011 Give or get quality laboratory services/tests in a timely manner to meet the needs of residents. Isolated/Minimal harm or potential for actual harm

Fire Safety Survey: CAMPBELLSVILLE NURSING AND REHABILITATION CENTER
Fire Safety Survey Summary on 2013-06-13
Total Number of Fire SafetyDeficiencies 0
Scope and Severity of most Severe Health Deficiency
Fire Safety Survey Summary on 2012-03-29
Total Number of Fire SafetyDeficiencies 0
Scope and Severity of most Severe Health Deficiency
Fire Safety Survey Summary on 2011-03-23
Total Number of Fire SafetyDeficiencies 2
Scope and Severity of most Severe Health Deficiency Widespread /Minimal harm or potential for actual harm
Fire Safety Survey: CAMPBELLSVILLE NURSING AND REHABILITATION CENTER
Fire Safety Survey Results: 03/23/2011
Corrected Deficiency Severity
05/08/2011 Properly installed electrical wiring and equipment. Pattern/Minimal harm or potential for actual harm
05/08/2011 An approved installation, maintenance and testing program for fire alarm systems. Widespread /Minimal harm or potential for actual harm

Resident Complaints: CAMPBELLSVILLE NURSING AND REHABILITATION CENTER
Date Complaint Substantiated: 07/25/2011
CorrectedCategoryDeficiencySeverity
08/19/2011Maintain drug records and properly mark/label drugs and other similar products according to accepted professional standards. E

Quality Measures: CAMPBELLSVILLE NURSING AND REHABILITATION CENTER
Quality Measures National Average Kentucky Average CAMPBELLSVILLE NURSING AND REHABILITATION CENTER
Overall quality rating NA NA 4
4
Long-Stay Residents
Percent of Long Stay Residents Whose Need for Help with ADLs has Increased 15.4% 17.0% 13.3%
Percent of Long Stay Residents Who Self Report Moderate to Severe Pain 8.3% 9.6% 2.6%
Percent of High Risk Long Stay Residents With Pressure Ulcers 6.1% 6.6% 4.7%
Percent of Long Stay Residents Who Lose Too Much Weight 7.2% 8.2% 3.7%
Percent of Low Risk Long Stay Residents Who Lose Control of Their Bowel or Bladder 43.9% 45.7% 40.0%
Percent of Long Stay Residents with a Catheter Inserted and Left in Their Bladder 3.2% 4.1% 4.9%
Percent of Long Stay Residents With a Urinary Tract Infection 6.2% 7.5% 22.1%
Percent of Long Stay Residents Who Have Depressive Symptoms 6.3% 4.6% 8.2%
Percent of Long Stay Residents Who Were Physically Restrained 1.4% 2.7% 0.0%
Percent of Long Stay Residents Experiencing One or More Falls with Major Injury 3.2% 4.0% 3.6%
Percent of Long Stay Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine 92.7% 94.7% 96.9%
Percent of Long Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 94.3% 97.1% 100.0%
Percent of Long Stay Residents Who Received an Antipsychotic Medication 20.7% 22.2% 31.8%
Short-Stay Residents
Percent of Short Stay Residents Who Self Report Moderate to Severe Pain 19.2% 21.9% 7.9%
Percent of Short Stay Residents With Pressure Ulcers That Are New or Worsened 1.2% 1.4% 1.6%
Percent of Short Stay Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine 83.4% 88.5% 97.7%
Percent of Short Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine 82.4% 87.8% 93.6%
Percent of Short Stay Residents Who Newly Received an Antipsychotic Medication 2.6% 3.1% 2.2%

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