Benton Rehab & Hcc - Benton Nursing Home
General Information
UPDATEFederal Provider Number
146121
Provider Name
BENTON REHAB & HCC
Provider Address
1409 NORTH MAIN STREET, PO BOX 847
BENTON, IL 62812
BENTON, IL 62812
Provider Phone Number
(618) 435-2712
Provider SSA County
360
Provider County Name
Franklin
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
67
Number of Residents in Certified Beds
31
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PETERSEN HEALTH OPERATIONS, LLC
Date First Approved to Provide Medicare and Medicaid services
2008-03-05
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
1
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
1
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
1.95806
Reported LPN Staffing Hours per Resident per Day
0.84194
Reported RN Staffing Hours per Resident per Day
0.56290
Reported Licensed Staffing Hours per Resident per Day
1.40484
Reported Total Nurse Staffing Hours per Resident per Day
3.36290
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00645
Expected CNA Staffing Hours per Resident per Day
2.42389
Expected LPN Staffing Hours per Resident per Day
0.67117
Expected RN Staffing Hours per Resident per Day
0.96876
Expected Total Nurse Staffing Hours per Resident per Day
4.06382
Adjusted CNA Staffing Hours per Resident per Day
1.98214
Adjusted LPN Staffing Hours per Resident per Day
1.04118
Adjusted RN Staffing Hours per Resident per Day
0.43416
Adjusted Total Nurse Staffing Hours per Resident per Day
3.33566
Cycle 1 Total Number of Health Deficiencies
18
Cycle 1 Number of Standard Health Deficiencies
18
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
96
Cycle 1 Standard Survey Health Date
2015-03-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
96
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2014-02-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2013-01-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
60.66700
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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