Willow Rose Rehab & Health - Jerseyville Nursing Home
General Information
UPDATEFederal Provider Number
146040
Provider Name
WILLOW ROSE REHAB & HEALTH
Provider Address
410 FLETCHER
JERSEYVILLE, IL 62052
JERSEYVILLE, IL 62052
Provider Phone Number
6184986427
Provider SSA County
500
Provider County Name
Jersey
Ownership Type
For profit - Corporation
Number of Certified Beds
98
Number of Residents in Certified Beds
49
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PETERSEN HEALTH NETWORK, LLC
Date First Approved to Provide Medicare and Medicaid services
2003-01-01
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
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
1.60306
Reported LPN Staffing Hours per Resident per Day
0.50612
Reported RN Staffing Hours per Resident per Day
0.59898
Reported Licensed Staffing Hours per Resident per Day
1.10510
Reported Total Nurse Staffing Hours per Resident per Day
2.70816
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00612
Expected CNA Staffing Hours per Resident per Day
2.37364
Expected LPN Staffing Hours per Resident per Day
0.59302
Expected RN Staffing Hours per Resident per Day
0.82961
Expected Total Nurse Staffing Hours per Resident per Day
3.79627
Adjusted CNA Staffing Hours per Resident per Day
1.65713
Adjusted LPN Staffing Hours per Resident per Day
0.70837
Adjusted RN Staffing Hours per Resident per Day
0.53948
Adjusted Total Nurse Staffing Hours per Resident per Day
2.87554
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
15
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
104
Cycle 1 Standard Survey Health Date
2014-09-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
104
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
16
Cycle 2 Standard Health Survey Date
2013-08-22
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
6
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-10-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
61.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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
Jerseyville Nsg & Rehab Center
1001 South State Street |
JERSEYVILLE IL 62052 | 0.6 mile away
Jerseyville Manor
1251 North State Street |
JERSEYVILLE IL 62052 | 1.4 miles away
Robings Manor Rhc
502 North Main |
BRIGHTON IL 62012 | 11.1 miles away
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