Concordia Village Care Center

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Concordia Village Care Center was recognized and ceritified in 2012 by Centers for Medicare & Medicaid Services as one of model nursing home providers promoting health and improving quality of life. Concordia Village Care Center which is located in 4101 West Iles Avenue Springfield, 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. Concordia Village Care Center is being offered ceritified services and products in Illinois.

  4101 West Iles Avenue
       Springfield, IL 62711

  (217) 793-9429

County: Sangamon
Federal Provider Number: 146154

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Participates in: Medicare And Medicaid
Certified Date: Tuesday, May 1, 2012 (13 years certified)
Certified Agency: Centers for Medicare & Medicaid Services
Legal Business Name: Lutheran Retirement Center Association
Ownership Type: Non Profit - Church Related
Provider Changed Ownership in Last 12 Months: No

Type	Name	Role Description
Organization	Lutheran Senior Services	5% Or Greater Security Interest
Organization	Lutheran Senior Services	5% Or More Ownership Interest
Organization	Lutheran Senior Services	Operational/managerial Control
Person	Maryann Walker	W-2 Managing Employee
Person	Henry Walden	Director/officer
Person	Roger H Volk	Director/officer
Person	William Simmons	Director/officer
Person	Mark Schoedel	Director/officer
Person	Alvin Schmidt	Director/officer
Person	William Roth	Director/officer
Person	Carla Robinson-Rainey	Director/officer
Person	Mary Riggs	W-2 Managing Employee
Person	Michael Raso	Director/officer
Person	Herold Olsen	Director/officer
Person	Paul Ogier	W-2 Managing Employee
Person	Paul Ogier	Director/officer
Person	Kathleen Mueller	Director/officer
Person	Victor Muchow	Director/officer
Person	Orlando Krueger	Director/officer
Person	Dale Kreienkamp	Director/officer
Person	Janet Kraemer	Director/officer
Person	John R. Kotovsky	Director/officer
Person	Scott Hartwig	Director/officer
Person	Mark Gerberding	Director/officer
Person	Karl Dunajcik	Director/officer
Person	Dwight Dickinson	Director/officer
Person	Linda Marie Detring	W-2 Managing Employee
Person	Linda Marie Detring	Director/officer
Person	James R Dankenbring	Director/officer
Person	Joel Christiansen	Director/officer
Person	Jon Carls	Director/officer
Person	John Brandt	Director/officer
Person	Monica Boesdorfer	Director/officer
Person	Lee Bodendieck	Director/officer
Person	Janice Beane	Director/officer
Person	Carla Baum	Director/officer
Person	Norma Barr	Director/officer
Person	Richard Bagy	Director/officer

Provider Resides in Hospital: No
Number of Federally Certified Beds: 64
Number of Residents in Federally Certified Beds: 58 (91% occupied)
Continuing Care Retirement Community: Yes
Special Focus Facility: No
With a Resident and Family Council: Resident
Automatic Sprinkler Systems in All Required Areas: Yes

Survey Date: Friday, October 25, 2013
Survey Type: Health
Deficiency: F0225 (1) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) rep)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Friday, November 8, 2013
The inspection cycle of deficiency: 1 (the deficiency was found on a standard inspection)

Survey Date: Friday, October 25, 2013
Survey Type: Health
Deficiency: F0226 (Develop and implement policies for 1) screening and training employees; and the 2) prevention, ident)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Friday, November 8, 2013
The inspection cycle of deficiency: 1 (the deficiency was found on a standard inspection)

Survey Date: Friday, October 25, 2013
Survey Type: Health
Deficiency: F0441 (Have a program that investigates, controls and keeps infection from spreading.)
Scope Severity Code: F
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Friday, November 8, 2013
The inspection cycle of deficiency: 1 (the deficiency was found on a standard inspection)

Survey Date: Wednesday, October 23, 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: F
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Monday, November 11, 2013
The inspection cycle of deficiency: 1 (the deficiency was found on a standard inspection)

Survey Date: Wednesday, October 23, 2013
Survey Type: Fire Safety
Deficiency: K0062 (Automatic sprinkler systems that have been maintained in working order.)
Scope Severity Code: E
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Monday, November 4, 2013
The inspection cycle of deficiency: 1 (the deficiency was found on a standard inspection)

Survey Date: Friday, November 2, 2012
Survey Type: Health
Deficiency: F0314 (Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Wednesday, December 5, 2012
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Friday, November 2, 2012
Survey Type: Health
Deficiency: F0226 (Develop and implement policies for 1) screening and training employees; and the 2) prevention, ident)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Wednesday, December 5, 2012
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Friday, November 2, 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: Wednesday, December 5, 2012
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Friday, November 2, 2012
Survey Type: Health
Deficiency: F0311 (Make sure that residents receive treatments/services to maintain or improve their ability to care fo)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Wednesday, December 5, 2012
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Friday, November 2, 2012
Survey Type: Health
Deficiency: F0318 (Ensure that residents with limited range of motion receive appropriate treatment and services to inc)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Wednesday, December 5, 2012
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Friday, November 2, 2012
Survey Type: Health
Deficiency: F0323 (Ensure that a nursing home area is free from accident hazards and provide adequate supervision to pr)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Wednesday, December 5, 2012
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Friday, November 2, 2012
Survey Type: Health
Deficiency: F0315 (Ensure that each resident who enters the nursing home without a catheter is not given a catheter, un)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Wednesday, December 5, 2012
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Friday, November 2, 2012
Survey Type: Health
Deficiency: F0225 (1) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) rep)
Scope Severity Code: D
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Wednesday, December 5, 2012
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Wednesday, October 31, 2012
Survey Type: Fire Safety
Deficiency: K0050 (Record of quarterly fire drills for each shift under varying conditions.)
Scope Severity Code: C
Deficiency Corrected: Deficient, Provider Has Plan Of Correction
Date the deficiency was corrected: Saturday, December 1, 2012
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Wednesday, October 31, 2012
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: F
Deficiency Corrected: Deficient, Provider Has No Plan Of Correction
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Wednesday, October 31, 2012
Survey Type: Fire Safety
Deficiency: K0062 (Automatic sprinkler systems that have been maintained in working order.)
Scope Severity Code: E
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Saturday, December 1, 2012
The inspection cycle of deficiency: 2 (the deficiency was found on a standard inspection)

Survey Date: Tuesday, April 3, 2012
Survey Type: Fire Safety
Deficiency: K0051 (A fire alarm system that can be heard throughout the facility.)
Scope Severity Code: F
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Tuesday, May 1, 2012
The inspection cycle of deficiency: 3 (the deficiency was found on a standard inspection)

Survey Date: Tuesday, April 3, 2012
Survey Type: Fire Safety
Deficiency: K0011 (A two-hour-resistant firewall separation.)
Scope Severity Code: F
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Monday, April 9, 2012
The inspection cycle of deficiency: 3 (the deficiency was found on a standard inspection)

Survey Date: Tuesday, April 3, 2012
Survey Type: Fire Safety
Deficiency: K0145 (The appropriate emergency electrical system.)
Scope Severity Code: F
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Wednesday, April 18, 2012
The inspection cycle of deficiency: 3 (the deficiency was found on a standard inspection)

Survey Date: Tuesday, April 3, 2012
Survey Type: Fire Safety
Deficiency: K0106 (Proper power supply for life support equipment.)
Scope Severity Code: F
Deficiency Corrected: Deficient, Provider Has Date Of Correction
Date the deficiency was corrected: Wednesday, April 18, 2012
The inspection cycle of deficiency: 3 (the deficiency was found on a standard inspection)

Survey Date: Wednesday, March 21, 2012
Survey Type: Health
Deficiency: F0387 (Make sure that doctors visit residents regularly, as required.)
Scope Severity Code: B
Deficiency Corrected: Deficient, Provider Has Plan Of Correction
Date the deficiency was corrected: Thursday, March 22, 2012
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	(5 out of 5 stars)
RN Staffing Rating	(5 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	6%	6%
Percent of Long Stay Residents Experiencing One or More Falls with Major Injury	N/A	3%	3%
Percent of Long Stay Residents Who Self Report Moderate to Severe Pain	N/A	6%	8%
Percent of Long Stay Residents Who Were Physically Restrained	N/A	1%	1%
Percent of Long Stay Residents Whose Need for Help with ADLs has Increased	N/A	16%	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	6%	6%
Percent of Short Stay Residents Who Self Report Moderate to Severe Pain	N/A	17%	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	94%	94%
Percent of Long Stay Residents Assessed and Appropriately Given the Seasonal Influenza Vaccine	N/A	93%	94%
Percent of Long Stay Residents Who Have Depressive Symptoms	N/A	14%	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	24%	20%
Percent of Low Risk Long Stay Residents Who Lose Control of Their Bowel or Bladder	N/A	37%	44%
Percent of Short Stay Residents Assessed and Appropriately Given the Pneumococcal Vaccine	N/A	81%	83%
Percent of Short Stay Residents Who Newly Received an Antipsychotic Medication	N/A	2%	2%
Percent of Short Stay Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine	N/A	82%	84%

N/A

Data not available.

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