Eastview Terrace - Sullivan Nursing Home
General Information
UPDATEFederal Provider Number
146039
Provider Name
EASTVIEW TERRACE
Provider Address
100 EASTVIEW PLACE
SULLIVAN, IL 61951
SULLIVAN, IL 61951
Provider Phone Number
(217) 728-7367
Provider SSA County
780
Provider County Name
Moultrie
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
63
Number of Residents in Certified Beds
51
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PETERSEN HEALTH QUALITY LLC
Date First Approved to Provide Medicare and Medicaid services
2002-12-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
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
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.71471
Reported LPN Staffing Hours per Resident per Day
0.47745
Reported RN Staffing Hours per Resident per Day
0.66373
Reported Licensed Staffing Hours per Resident per Day
1.14118
Reported Total Nurse Staffing Hours per Resident per Day
2.85589
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04608
Expected CNA Staffing Hours per Resident per Day
2.39244
Expected LPN Staffing Hours per Resident per Day
0.64903
Expected RN Staffing Hours per Resident per Day
0.93271
Expected Total Nurse Staffing Hours per Resident per Day
3.97418
Adjusted CNA Staffing Hours per Resident per Day
1.75861
Adjusted LPN Staffing Hours per Resident per Day
0.61058
Adjusted RN Staffing Hours per Resident per Day
0.53172
Adjusted Total Nurse Staffing Hours per Resident per Day
2.89665
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2014-09-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-11-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-12-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
45.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
8
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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