Illinois Nursing Homes >> Gifford Nursing Homes >> Country Health

Country Health - Gifford Nursing Home

General Information

UPDATE
Federal Provider Number
145708
Provider Name
COUNTRY HEALTH
Provider Address
2304 C R 3000 N
GIFFORD, IL 61847
Provider Phone Number
2175687362
Provider SSA County
90
Provider County Name
Champaign
Ownership Type
Non profit - Other
Number of Certified Beds
89
Number of Residents in Certified Beds
84
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTRY HEALTH, INC.
Date First Approved to Provide Medicare and Medicaid services
1992-03-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.86190
Reported LPN Staffing Hours per Resident per Day
0.64881
Reported RN Staffing Hours per Resident per Day
0.76250
Reported Licensed Staffing Hours per Resident per Day
1.41131
Reported Total Nurse Staffing Hours per Resident per Day
3.27321
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07381
Expected CNA Staffing Hours per Resident per Day
2.41930
Expected LPN Staffing Hours per Resident per Day
0.60105
Expected RN Staffing Hours per Resident per Day
0.95154
Expected Total Nurse Staffing Hours per Resident per Day
3.97190
Adjusted CNA Staffing Hours per Resident per Day
1.88837
Adjusted LPN Staffing Hours per Resident per Day
0.89595
Adjusted RN Staffing Hours per Resident per Day
0.59875
Adjusted Total Nurse Staffing Hours per Resident per Day
3.32183
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-10-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-09-18
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-10-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
33.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01

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