Fairfield Memorial Hospital - Fairfield Nursing Home
General Information
UPDATEFederal Provider Number
145552
Provider Name
FAIRFIELD MEMORIAL HOSPITAL
Provider Address
NORTH WEST 11TH STREET
FAIRFIELD, IL 62837
FAIRFIELD, IL 62837
Provider Phone Number
6188422611
Provider SSA County
986
Provider County Name
Wayne
Ownership Type
Non profit - Other
Number of Certified Beds
30
Number of Residents in Certified Beds
20
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION
Date First Approved to Provide Medicare and Medicaid services
1986-03-26
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.14250
Reported LPN Staffing Hours per Resident per Day
0.28500
Reported RN Staffing Hours per Resident per Day
2.17000
Reported Licensed Staffing Hours per Resident per Day
2.45500
Reported Total Nurse Staffing Hours per Resident per Day
5.59750
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01750
Expected CNA Staffing Hours per Resident per Day
2.36746
Expected LPN Staffing Hours per Resident per Day
0.63081
Expected RN Staffing Hours per Resident per Day
1.00315
Expected Total Nurse Staffing Hours per Resident per Day
4.00142
Adjusted CNA Staffing Hours per Resident per Day
3.25698
Adjusted LPN Staffing Hours per Resident per Day
0.37500
Adjusted RN Staffing Hours per Resident per Day
1.61633
Adjusted Total Nurse Staffing Hours per Resident per Day
5.63874
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-09-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-10-31
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
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-11-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
21.33300
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
Nursiong Homes Nearby
Way-fair Nursing & Rehab Center
305 N.w. 11th Street |
FAIRFIELD IL 62837 | 0 mile away
Cisne Rehabilitation & Health Center
Watkins Street, P O Box 370 |
CISNE IL 62823 | 9.9 miles away
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