Magnolia Village

MEDICARE CERTIFIED

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Magnolia Village was recognized and ceritified in 1997 by Centers for Medicare & Medicaid Services as one of model nursing home providers promoting health and improving quality of life. Magnolia Village which is located in 1381 Campbell Lane Bowling Green, is scientifically measured and assessed by Centers for Medicare & Medicaid Services and is shown to provide good nursing home services or products under the Medicare program. Magnolia Village is being offered ceritified services and products in Kentucky.

  1381 Campbell Lane
       Bowling Green, KY 42104

  (270) 843-0587

County: Warren
Federal Provider Number: 185435

Map and Directions

Participates in: Medicare And Medicaid
Certified Date: Thursday, June 19, 1997 (28 years certified)
Certified Agency: Centers for Medicare & Medicaid Services
Legal Business Name: Hbr Campbell Lane, Llc
Ownership Type: For Profit - Corporation
Provider Changed Ownership in Last 12 Months: No

Type	Name	Role Description
Organization	Gen Management Llc	5% Or More Ownership Interest
Organization	Gazelle Gen Llc	5% Or More Ownership Interest
Organization	Fc-Gen Operations Investment Llc	5% Or More Ownership Interest
Organization	Donna Reis 1995 Fam Tr	5% Or More Ownership Interest
Organization	Barclays Bank Plc	5% Or Greater Security Interest
Organization	Gen Operations I Llc	5% Or More Ownership Interest
Organization	Gen Operations Ii, Llc	5% Or More Ownership Interest
Organization	General Electric Capital Corporation	5% Or Greater Security Interest
Organization	Genesis Healthcare Llc	5% Or More Ownership Interest
Organization	Ghc Holdings Ii Llc	5% Or More Ownership Interest
Organization	Harborside Healthcare Advisors Limited Partnership	5% Or More Ownership Interest
Organization	Harborside Healthcare, Lp	5% Or More Ownership Interest
Organization	Hbr Campbell Lane, Llc	5% Or More Ownership Interest
Organization	Hbr Kentucky	5% Or More Ownership Interest
Organization	Hccf Management Group Xi Llc	5% Or More Ownership Interest
Organization	Senior Care Genesis Llc	5% Or More Ownership Interest
Organization	Senior Care Holdings, Llc	5% Or More Ownership Interest
Organization	Sl Gen Llc	5% Or More Ownership Interest
Organization	Zac Properties Xi Llc	5% Or More Ownership Interest
Person	Stephen Young	Director/officer
Person	Joseph Wilks	Director/officer
Person	Arnold Whitman	Director/officer
Person	Arnold Whitman	5% Or More Ownership Interest
Person	David Stordy	Director/officer
Person	Kenneth Silverwood	Director/officer
Person	Michael Sherman	Operational/managerial Control
Person	Michael Sherman	Director/officer
Person	Norman Schueftan	Director/officer
Person	Israel Rosenblum	Director/officer
Person	Robert Reitz	Operational/managerial Control
Person	Robert Reitz	Director/officer
Person	David Reis	Director/officer
Person	Joanne Reifsnyder	Director/officer
Person	Kelly Priegnitz	Director/officer
Person	Jeanne Phillips	Director/officer
Person	Garry Pezzano	Director/officer
Person	Lawrence Newman	Director/officer
Person	Isaac Neuberger	Director/officer
Person	Michael Montevideo	Director/officer
Person	William Mathies	Director/officer
Person	Joseph Mason	Operational/managerial Control
Person	Joseph Mason	Director/officer
Person	Laurence Lane	Director/officer
Person	Brian Jaggers	W-2 Managing Employee
Person	Bennett Hoffman	Director/officer
Person	Daniel Hirschfeld	Director/officer
Person	Charles Herman	Director/officer
Person	Robert Hartman	Director/officer
Person	Robert Hartman	5% Or More Ownership Interest
Person	George Hager	Operational/managerial Control
Person	George Hager	Director/officer
Person	Steven Fishman	Director/officer
Person	Steven Fishman	5% Or More Ownership Interest
Person	Christina Firth	Director/officer
Person	Jan Edwards	Director/officer
Person	Joseph Dvorak	Director/officer
Person	Thomas Divittorio	Operational/managerial Control
Person	Thomas Divittorio	Director/officer
Person	Keith Davis	Operational/managerial Control
Person	Keith Davis	Director/officer
Person	Richard Castor	Director/officer
Person	Joseph Bourne	Director/officer
Person	David Bertha	Director/officer
Person	Michael Berg	Operational/managerial Control
Person	Michael Berg	Director/officer
Person	Jeffrey Berenbach	Operational/managerial Control
Person	Jeffrey Berenbach	Director/officer
Person	Brian Beckwith	Director/officer
Person	David Almquist	Operational/managerial Control
Person	David Almquist	Director/officer

Provider Resides in Hospital: No
Number of Federally Certified Beds: 60
Number of Residents in Federally Certified Beds: 60 (100% occupied)
Continuing Care Retirement Community: No
Special Focus Facility: No
With a Resident and Family Council: Family
Automatic Sprinkler Systems in All Required Areas: Yes

Survey Date: Thursday, September 19, 2013
Survey Type: Health
Deficiency: F0253 (Provide housekeeping and maintenance services.)
Scope Severity Code: E
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Friday, October 18, 2013
The inspection cycle of deficiency: 1 (the deficiency was found on a standard inspection)

Survey Date: Wednesday, September 18, 2013
Survey Type: Fire Safety
Deficiency: K0068 (An externally vented heating system.)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Saturday, October 19, 2013
The inspection cycle of deficiency: 1 (the deficiency was found on a standard inspection)

Survey Date: Wednesday, September 18, 2013
Survey Type: Fire Safety
Deficiency: K0029 (Special areas constructed so that walls can resist fire for one hour or an approved fire extinguishi)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Friday, October 18, 2013
The inspection cycle of deficiency: 1 (the deficiency was found on a standard inspection)

Survey Date: Wednesday, September 18, 2013
Survey Type: Fire Safety
Deficiency: K0038 (Exits that are accessible at all times.)
Scope Severity Code: E
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Friday, October 18, 2013
The inspection cycle of deficiency: 1 (the deficiency was found on a standard inspection)

Survey Date: Wednesday, September 18, 2013
Survey Type: Fire Safety
Deficiency: K0056 (An approved automatic sprinkler system connected to the fire alarm system.)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Friday, October 18, 2013
The inspection cycle of deficiency: 1 (the deficiency was found on a standard inspection)

Survey Date: Thursday, December 13, 2012
Survey Type: Health
Deficiency: F0248 (Provide activities to meet the interests and needs of each resident.)
Scope Severity Code: E
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Monday, January 14, 2013
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Thursday, December 13, 2012
Survey Type: Health
Deficiency: F0252 (Provide a safe, clean, comfortable and home-like environment; and allow residents to use personal be)
Scope Severity Code: E
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Monday, January 14, 2013
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Thursday, December 13, 2012
Survey Type: Health
Deficiency: F0309 (Provide necessary care and services to maintain or improve the highest well being of each resident .)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Monday, January 14, 2013
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Thursday, December 13, 2012
Survey Type: Health
Deficiency: F0167 (Allow residents to easily view the results of the nursing home's most recent inspection.)
Scope Severity Code: C
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Monday, January 14, 2013
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Thursday, December 13, 2012
Survey Type: Health
Deficiency: F0441 (Have a program that investigates, controls and keeps infection from spreading.)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Monday, January 14, 2013
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Thursday, December 13, 2012
Survey Type: Health
Deficiency: F0253 (Provide housekeeping and maintenance services.)
Scope Severity Code: E
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Monday, January 14, 2013
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Tuesday, December 11, 2012
Survey Type: Fire Safety
Deficiency: K0068 (An externally vented heating system.)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Monday, January 14, 2013
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Tuesday, December 11, 2012
Survey Type: Fire Safety
Deficiency: K0045 (Proper backup exit lighting.)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Monday, January 14, 2013
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Tuesday, December 11, 2012
Survey Type: Fire Safety
Deficiency: K0025 (Walls that prevent smoke from passing through and would resist fire for at least one hour.)
Scope Severity Code: E
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Monday, January 14, 2013
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Tuesday, December 11, 2012
Survey Type: Fire Safety
Deficiency: K0147 (Properly installed electrical wiring and equipment.)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Monday, January 14, 2013
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Tuesday, December 11, 2012
Survey Type: Fire Safety
Deficiency: K0072 (Exits that are free from obstructions and can be used at all times.)
Scope Severity Code: E
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Monday, January 14, 2013
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Tuesday, December 11, 2012
Survey Type: Fire Safety
Deficiency: K0062 (Automatic sprinkler systems that have been maintained in working order.)
Scope Severity Code: F
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Monday, January 14, 2013
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Thursday, September 8, 2011
Survey Type: Health
Deficiency: F0253 (Provide housekeeping and maintenance services.)
Scope Severity Code: E
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Thursday, September 29, 2011
The inspection cycle of deficiency: 3 (the deficiency was found on a standard inspection)

Survey Date: Wednesday, September 7, 2011
Survey Type: Fire Safety
Deficiency: K0056 (An approved automatic sprinkler system connected to the fire alarm system.)
Scope Severity Code: E
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Thursday, October 20, 2011
The inspection cycle of deficiency: 3 (the deficiency was found on a standard inspection)

Number of Facility Reported Incidents: 0
Number of Substantiated Complaints: 0
Number of Fines: 0
Number of Payment Denials: 0
Total Number of Penalties: 0
Total Amount of Fines in Dollars: USD 0

This data allows consumers to compare information about nursing homes. Information here is not an endorsement or advertisement for any nursing home and should be considered carefully. Use it with other information you gather about nursing homes facilities. Talk to your doctor or other health care provider about this.

This data was updated by using data source from Centers for Medicare and Medicaid Services (CMS) which is publicized on Wednesday, October 1, 2014. If you found out that something incorrect and want to change it, please follow this Update Data guide.

The Five Star Quality Rating System is not a substitute for visiting the nursing home. This system can give you important information, help you compare nursing homes by topics you consider most important, and help you think of questions to ask when you visit the nursing home. Use the Five-Star ratings together with other sources of information.

items	rating
Health Inspection Rating	(4 out of 5 stars)
Quality Rating	(5 out of 5 stars)
Staffing Rating	(2 out of 5 stars)
RN Staffing Rating	(3 out of 5 stars)
Overall Rating	(5 out of 5 stars)

Nursing homes vary in the quality of care and services they provide to their residents. Reviewing health inspection results, staffing data, and quality measure data are three important ways to measure nursing home quality. This information gives you a "snap shot" of the care individual nursing home give.

Patients experiences	Provider	State	Nation
Percent of High Risk Long Stay Residents With Pressure Ulcers	N/A	7%	6%
Percent of Long Stay Residents Experiencing One or More Falls with Major Injury	N/A	4%	3%
Percent of Long Stay Residents Who Self Report Moderate to Severe Pain	N/A	9%	8%
Percent of Long Stay Residents Who Were Physically Restrained	N/A	2%	1%
Percent of Long Stay Residents Whose Need for Help with ADLs has Increased	N/A	17%	16%
Percent of Long Stay Residents with a Catheter Inserted and Left in Their Bladder	N/A	4%	3%
Percent of Long Stay Residents With a Urinary Tract Infection	N/A	7%	6%
Percent of Short Stay Residents Who Self Report Moderate to Severe Pain	N/A	22%	19%
Percent of Short Stay Residents With Pressure Ulcers That Are New or Worsened	N/A	1%	1%
Percent of Long Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine	N/A	97%	94%
Percent of Long Stay Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine	N/A	96%	94%
Percent of Long Stay Residents Who Have Depressive Symptoms	N/A	4%	6%
Percent of Long Stay Residents Who Lose Too Much Weight	N/A	8%	7%
Percent of Long Stay Residents Who Received an Antipsychotic Medication	N/A	22%	20%
Percent of Low Risk Long Stay Residents Who Lose Control of Their Bowel or Bladder	N/A	48%	44%
Percent of Short Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine	N/A	88%	83%
Percent of Short Stay Residents Who Newly Received an Antipsychotic Medication	N/A	3%	2%
Percent of Short Stay Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine	N/A	88%	84%

N/A

Data not available.

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