Farmington Country Manor - Farmington Nursing Home
General Information
UPDATEFederal Provider Number
145404
Provider Name
FARMINGTON COUNTRY MANOR
Provider Address
701 SOUTH MAIN STREET
FARMINGTON, IL 61531
FARMINGTON, IL 61531
Provider Phone Number
(309) 245-2408
Provider SSA County
370
Provider County Name
Fulton
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
92
Number of Residents in Certified Beds
75
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
AMERICAN HEALTH CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1980-08-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
1.97067
Reported LPN Staffing Hours per Resident per Day
0.67533
Reported RN Staffing Hours per Resident per Day
0.69800
Reported Licensed Staffing Hours per Resident per Day
1.37333
Reported Total Nurse Staffing Hours per Resident per Day
3.34400
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08867
Expected CNA Staffing Hours per Resident per Day
2.39928
Expected LPN Staffing Hours per Resident per Day
0.53802
Expected RN Staffing Hours per Resident per Day
0.77229
Expected Total Nurse Staffing Hours per Resident per Day
3.70958
Adjusted CNA Staffing Hours per Resident per Day
2.01537
Adjusted LPN Staffing Hours per Resident per Day
1.04184
Adjusted RN Staffing Hours per Resident per Day
0.67533
Adjusted Total Nurse Staffing Hours per Resident per Day
3.63366
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2015-03-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2014-04-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2013-05-23
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
16.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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