Heritage Health-carlinville - Carlinville Nursing Home
General Information
UPDATEFederal Provider Number
145456
Provider Name
HERITAGE HEALTH-CARLINVILLE
Provider Address
1200 UNIVERSITY AVENUE
CARLINVILLE, IL 62626
CARLINVILLE, IL 62626
Provider Phone Number
2178544433
Provider SSA County
670
Provider County Name
Macoupin
Ownership Type
For profit - Corporation
Number of Certified Beds
108
Number of Residents in Certified Beds
71
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HERITAGE MANOR - CARLINVILLE, L.L.C.
Date First Approved to Provide Medicare and Medicaid services
1982-12-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
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
0.75423
Reported LPN Staffing Hours per Resident per Day
0.39225
Reported RN Staffing Hours per Resident per Day
0.67676
Reported Licensed Staffing Hours per Resident per Day
1.06901
Reported Total Nurse Staffing Hours per Resident per Day
1.82324
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01197
Expected CNA Staffing Hours per Resident per Day
2.38626
Expected LPN Staffing Hours per Resident per Day
0.56278
Expected RN Staffing Hours per Resident per Day
0.83560
Expected Total Nurse Staffing Hours per Resident per Day
3.78464
Adjusted CNA Staffing Hours per Resident per Day
0.77555
Adjusted LPN Staffing Hours per Resident per Day
0.57849
Adjusted RN Staffing Hours per Resident per Day
0.60516
Adjusted Total Nurse Staffing Hours per Resident per Day
1.94187
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
44
Cycle 1 Standard Survey Health Date
2014-06-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
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
4
Cycle 2 Standard Health Survey Date
2013-07-18
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
15
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
619
Cycle 3 Standard Health Survey Date
2012-05-31
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
310
Cycle 3 Total Health Score
929
Total Weighted Health Survey Score
178.16700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
50400
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Friendship Skilled Nsg & Rehab
826 North High |
CARLINVILLE IL 62626 | 0.4 mile away
Carlinville Rehab & Hcc
751 North Oak Street |
CARLINVILLE IL 62626 | 0.7 mile away
Pleasant Hill Healthcare
1010 West North Street |
GIRARD IL 62640 | 11.7 miles away
Heritage Health-gillespie
7588 Staunton Road |
GILLESPIE IL 62033 | 13.1 miles away
Sunrise Skilled Nursing & Rehab
333 South Wrightsman Street |
VIRDEN IL 62690 | 15 miles away
Heritage Health-staunton
215 West Pennsylvania Avenue |
STAUNTON IL 62088 | 19.7 miles away
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