Alpine Fireside Health Center - Rockford Nursing Home
General Information
UPDATEFederal Provider Number
146066
Provider Name
ALPINE FIRESIDE HEALTH CENTER
Provider Address
3650 NORTH ALPINE ROAD
ROCKFORD, IL 61114
ROCKFORD, IL 61114
Provider Phone Number
(815) 877-7408
Provider SSA County
991
Provider County Name
Winnebago
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
66
Number of Residents in Certified Beds
41
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ALPINE FIRESIDE HEALTH CENTER LTD
Date First Approved to Provide Medicare and Medicaid services
2004-08-09
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
3
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
4.57805
Reported LPN Staffing Hours per Resident per Day
0.79268
Reported RN Staffing Hours per Resident per Day
1.37561
Reported Licensed Staffing Hours per Resident per Day
2.16829
Reported Total Nurse Staffing Hours per Resident per Day
6.74634
Reported Physical Therapist Staffing Hours per Resident Per Day
0.18659
Expected CNA Staffing Hours per Resident per Day
2.39509
Expected LPN Staffing Hours per Resident per Day
0.61184
Expected RN Staffing Hours per Resident per Day
1.07109
Expected Total Nurse Staffing Hours per Resident per Day
4.07802
Adjusted CNA Staffing Hours per Resident per Day
4.69007
Adjusted LPN Staffing Hours per Resident per Day
1.07532
Adjusted RN Staffing Hours per Resident per Day
0.95964
Adjusted Total Nurse Staffing Hours per Resident per Day
6.66839
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
8
Cycle 1 Standard Survey Health Date
2014-10-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
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
20
Cycle 2 Standard Health Survey Date
2013-09-26
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-11-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
14.00000
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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