Fairview Haven - Fairbury Nursing Home
General Information
UPDATEFederal Provider Number
145794
Provider Name
FAIRVIEW HAVEN
Provider Address
605 NORTH 4TH STREET
FAIRBURY, IL 61739
FAIRBURY, IL 61739
Provider Phone Number
(815) 692-2572
Provider SSA County
610
Provider County Name
Livingston
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
63
Number of Residents in Certified Beds
61
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FAIRVIEW HAVEN INC
Date First Approved to Provide Medicare and Medicaid services
1994-07-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
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
3.00492
Reported LPN Staffing Hours per Resident per Day
0.77787
Reported RN Staffing Hours per Resident per Day
0.60082
Reported Licensed Staffing Hours per Resident per Day
1.37869
Reported Total Nurse Staffing Hours per Resident per Day
4.38361
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02705
Expected CNA Staffing Hours per Resident per Day
2.27104
Expected LPN Staffing Hours per Resident per Day
0.57031
Expected RN Staffing Hours per Resident per Day
0.79597
Expected Total Nurse Staffing Hours per Resident per Day
3.63733
Adjusted CNA Staffing Hours per Resident per Day
3.24660
Adjusted LPN Staffing Hours per Resident per Day
1.13207
Adjusted RN Staffing Hours per Resident per Day
0.56401
Adjusted Total Nurse Staffing Hours per Resident per Day
4.85793
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-06-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-07-23
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
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
8
Cycle 3 Standard Health Survey Date
2012-08-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
24.66700
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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