Douglas Nursing & Rehab Center - Mattoon Nursing Home
General Information
UPDATEFederal Provider Number
145503
Provider Name
DOUGLAS NURSING & REHAB CENTER
Provider Address
3516 POWELL LANE
MATTOON, IL 61938
MATTOON, IL 61938
Provider Phone Number
(217) 234-6401
Provider SSA County
140
Provider County Name
Coles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
79
Number of Residents in Certified Beds
39
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
DOUGLAS REHABILITATION AND CARE
Date First Approved to Provide Medicare and Medicaid services
1984-11-01
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
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
2.57949
Reported LPN Staffing Hours per Resident per Day
0.79872
Reported RN Staffing Hours per Resident per Day
0.61538
Reported Licensed Staffing Hours per Resident per Day
1.41410
Reported Total Nurse Staffing Hours per Resident per Day
3.99359
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06538
Expected CNA Staffing Hours per Resident per Day
2.34780
Expected LPN Staffing Hours per Resident per Day
0.73740
Expected RN Staffing Hours per Resident per Day
1.10128
Expected Total Nurse Staffing Hours per Resident per Day
4.18648
Adjusted CNA Staffing Hours per Resident per Day
2.69584
Adjusted LPN Staffing Hours per Resident per Day
0.89902
Adjusted RN Staffing Hours per Resident per Day
0.41752
Adjusted Total Nurse Staffing Hours per Resident per Day
3.84518
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-07-24
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
9
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2013-08-09
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
68
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-06-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
48.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
7
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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