Apostolic Christian Skylines - Peoria Nursing Home
General Information
UPDATEFederal Provider Number
145933
Provider Name
APOSTOLIC CHRISTIAN SKYLINES
Provider Address
7023 NORTH EAST SKYLINE DRIVE
PEORIA, IL 61614
PEORIA, IL 61614
Provider Phone Number
(309) 691-8091
Provider SSA County
800
Provider County Name
Peoria
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
57
Number of Residents in Certified Beds
56
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
APOSTOLIC CHRISTIAN HOME
Date First Approved to Provide Medicare and Medicaid services
1997-05-01
Continuing Care Retirement Community
Y
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
5
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
3.57500
Reported LPN Staffing Hours per Resident per Day
0.68482
Reported RN Staffing Hours per Resident per Day
1.17946
Reported Licensed Staffing Hours per Resident per Day
1.86429
Reported Total Nurse Staffing Hours per Resident per Day
5.43928
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01250
Expected CNA Staffing Hours per Resident per Day
2.72170
Expected LPN Staffing Hours per Resident per Day
0.54430
Expected RN Staffing Hours per Resident per Day
0.72187
Expected Total Nurse Staffing Hours per Resident per Day
3.98787
Adjusted CNA Staffing Hours per Resident per Day
3.22298
Adjusted LPN Staffing Hours per Resident per Day
1.04428
Adjusted RN Staffing Hours per Resident per Day
1.22084
Adjusted Total Nurse Staffing Hours per Resident per Day
5.49797
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2015-03-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
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
2014-04-03
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
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2013-05-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
24.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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