Jerseyville Nsg & Rehab Center - Jerseyville Nursing Home
General Information
UPDATEFederal Provider Number
145465
Provider Name
JERSEYVILLE NSG & REHAB CENTER
Provider Address
1001 SOUTH STATE STREET
JERSEYVILLE, IL 62052
JERSEYVILLE, IL 62052
Provider Phone Number
6184986496
Provider SSA County
500
Provider County Name
Jersey
Ownership Type
For profit - Corporation
Number of Certified Beds
111
Number of Residents in Certified Beds
96
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1983-06-01
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.84167
Reported LPN Staffing Hours per Resident per Day
0.52240
Reported RN Staffing Hours per Resident per Day
0.58490
Reported Licensed Staffing Hours per Resident per Day
1.10729
Reported Total Nurse Staffing Hours per Resident per Day
3.94897
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04844
Expected CNA Staffing Hours per Resident per Day
2.60721
Expected LPN Staffing Hours per Resident per Day
0.63522
Expected RN Staffing Hours per Resident per Day
0.97151
Expected Total Nurse Staffing Hours per Resident per Day
4.21393
Adjusted CNA Staffing Hours per Resident per Day
2.67436
Adjusted LPN Staffing Hours per Resident per Day
0.68259
Adjusted RN Staffing Hours per Resident per Day
0.44986
Adjusted Total Nurse Staffing Hours per Resident per Day
3.77744
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
107
Cycle 1 Standard Survey Health Date
2015-01-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
107
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-02-24
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2013-03-14
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
53.50000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
39065
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Willow Rose Rehab & Health
410 Fletcher |
JERSEYVILLE IL 62052 | 0.6 mile away
Jerseyville Manor
1251 North State Street |
JERSEYVILLE IL 62052 | 1.8 miles away
Robings Manor Rhc
502 North Main |
BRIGHTON IL 62012 | 10.5 miles away
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