Eastside Health & Rehab Center - Pittsfield Nursing Home
General Information
UPDATEFederal Provider Number
145851
Provider Name
EASTSIDE HEALTH & REHAB CENTER
Provider Address
1400 EAST WASHINGTON STREET
PITTSFIELD, IL 62363
PITTSFIELD, IL 62363
Provider Phone Number
(217) 285-4491
Provider SSA County
830
Provider County Name
Pike
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
92
Number of Residents in Certified Beds
60
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
1996-01-01
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
3
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.30417
Reported LPN Staffing Hours per Resident per Day
0.75917
Reported RN Staffing Hours per Resident per Day
0.42083
Reported Licensed Staffing Hours per Resident per Day
1.18000
Reported Total Nurse Staffing Hours per Resident per Day
3.48417
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09500
Expected CNA Staffing Hours per Resident per Day
2.31117
Expected LPN Staffing Hours per Resident per Day
0.60914
Expected RN Staffing Hours per Resident per Day
0.93051
Expected Total Nurse Staffing Hours per Resident per Day
3.85081
Adjusted CNA Staffing Hours per Resident per Day
2.44627
Adjusted LPN Staffing Hours per Resident per Day
1.03443
Adjusted RN Staffing Hours per Resident per Day
0.33793
Adjusted Total Nurse Staffing Hours per Resident per Day
3.64711
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-04-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-06-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
52
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-05-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
30.66700
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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