A Merkle C Knipprath N H - Clifton Nursing Home
General Information
UPDATEFederal Provider Number
146085
Provider Name
A MERKLE C KNIPPRATH N H
Provider Address
1190 E 2900 NORTH ROAD
CLIFTON, IL 60927
CLIFTON, IL 60927
Provider Phone Number
(815) 694-2306
Provider SSA County
460
Provider County Name
Iroquois
Provider Website
Provider Description
Ownership Type
Non profit - Other
Number of Certified Beds
99
Number of Residents in Certified Beds
51
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ARTHUR MERKLE-CLARA KNIPPRATH NURSING HOME
Date First Approved to Provide Medicare and Medicaid services
2005-05-21
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
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
2.00000
Reported LPN Staffing Hours per Resident per Day
0.71275
Reported RN Staffing Hours per Resident per Day
0.60784
Reported Licensed Staffing Hours per Resident per Day
1.32059
Reported Total Nurse Staffing Hours per Resident per Day
3.32059
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11078
Expected CNA Staffing Hours per Resident per Day
2.28358
Expected LPN Staffing Hours per Resident per Day
0.57119
Expected RN Staffing Hours per Resident per Day
0.89305
Expected Total Nurse Staffing Hours per Resident per Day
3.74781
Adjusted CNA Staffing Hours per Resident per Day
2.14900
Adjusted LPN Staffing Hours per Resident per Day
1.03570
Adjusted RN Staffing Hours per Resident per Day
0.50857
Adjusted Total Nurse Staffing Hours per Resident per Day
3.57141
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
32
Cycle 1 Standard Survey Health Date
2014-04-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
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
12
Cycle 2 Standard Health Survey Date
2013-03-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-05-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
24.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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