Effingham Rehab & Health Care Ctr - Effingham Nursing Home
General Information
UPDATEFederal Provider Number
145514
Provider Name
EFFINGHAM REHAB & HEALTH CARE CTR
Provider Address
1610 NORTH LAKEWOOD
EFFINGHAM, IL 62401
EFFINGHAM, IL 62401
Provider Phone Number
(217) 347-7781
Provider SSA County
330
Provider County Name
Effingham
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
62
Number of Residents in Certified Beds
39
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PETERSEN HEALTH ENTERPRISES, LLC
Date First Approved to Provide Medicare and Medicaid services
1985-01-01
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
3
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.89744
Reported LPN Staffing Hours per Resident per Day
0.19359
Reported RN Staffing Hours per Resident per Day
0.95513
Reported Licensed Staffing Hours per Resident per Day
1.14872
Reported Total Nurse Staffing Hours per Resident per Day
3.04616
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01667
Expected CNA Staffing Hours per Resident per Day
2.39822
Expected LPN Staffing Hours per Resident per Day
0.63222
Expected RN Staffing Hours per Resident per Day
0.92993
Expected Total Nurse Staffing Hours per Resident per Day
3.96038
Adjusted CNA Staffing Hours per Resident per Day
1.94133
Adjusted LPN Staffing Hours per Resident per Day
0.25415
Adjusted RN Staffing Hours per Resident per Day
0.76745
Adjusted Total Nurse Staffing Hours per Resident per Day
3.10040
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-08-28
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
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-07-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
80
Cycle 3 Standard Health Survey Date
2012-09-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
80
Total Weighted Health Survey Score
30.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
Number of Fines
1
Total Amount of Fines in Dollars
2838
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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