Cisne Rehabilitation & Health Center - Cisne Nursing Home
General Information
UPDATEFederal Provider Number
146131
Provider Name
CISNE REHABILITATION & HEALTH CENTER
Provider Address
WATKINS STREET, P O BOX 370
CISNE, IL 62823
CISNE, IL 62823
Provider Phone Number
6186732177
Provider SSA County
986
Provider County Name
Wayne
Ownership Type
For profit - Corporation
Number of Certified Beds
35
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
2008-08-12
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
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
2.57742
Reported LPN Staffing Hours per Resident per Day
0.67742
Reported RN Staffing Hours per Resident per Day
0.83710
Reported Licensed Staffing Hours per Resident per Day
1.51452
Reported Total Nurse Staffing Hours per Resident per Day
4.09194
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01774
Expected CNA Staffing Hours per Resident per Day
2.76717
Expected LPN Staffing Hours per Resident per Day
0.80731
Expected RN Staffing Hours per Resident per Day
1.18104
Expected Total Nurse Staffing Hours per Resident per Day
4.75552
Adjusted CNA Staffing Hours per Resident per Day
2.28545
Adjusted LPN Staffing Hours per Resident per Day
0.69646
Adjusted RN Staffing Hours per Resident per Day
0.52960
Adjusted Total Nurse Staffing Hours per Resident per Day
3.46843
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-04-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-06-06
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
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-06-04
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
10.66700
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
Nursiong Homes Nearby
Way-fair Nursing & Rehab Center
305 N.w. 11th Street |
FAIRFIELD IL 62837 | 9.9 miles away
Fairfield Memorial Hospital
North West 11th Street |
FAIRFIELD IL 62837 | 9.9 miles away
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