Illinois Nursing Homes >> Cuba Nursing Homes >> Clayberg, The

Clayberg, The - Cuba Nursing Home

General Information

UPDATE
Federal Provider Number
146151
Provider Name
CLAYBERG, THE
Provider Address
625 EAST MONROE STREET
CUBA, IL 61427
Provider Phone Number
3097855012
Provider SSA County
370
Provider County Name
Fulton
Ownership Type
Government - County
Number of Certified Beds
49
Number of Residents in Certified Beds
47
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTY OF FULTON
Date First Approved to Provide Medicare and Medicaid services
2011-07-07
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
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
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
2.62872
Reported LPN Staffing Hours per Resident per Day
0.69362
Reported RN Staffing Hours per Resident per Day
0.58404
Reported Licensed Staffing Hours per Resident per Day
1.27766
Reported Total Nurse Staffing Hours per Resident per Day
3.90638
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01064
Expected CNA Staffing Hours per Resident per Day
2.31668
Expected LPN Staffing Hours per Resident per Day
0.55878
Expected RN Staffing Hours per Resident per Day
0.83555
Expected Total Nurse Staffing Hours per Resident per Day
3.71100
Adjusted CNA Staffing Hours per Resident per Day
2.78420
Adjusted LPN Staffing Hours per Resident per Day
1.03030
Adjusted RN Staffing Hours per Resident per Day
0.52228
Adjusted Total Nurse Staffing Hours per Resident per Day
4.24312
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-04-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2013-03-21
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
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-05-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
34.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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