Fireside House Of Centralia - Centralia Nursing Home
General Information
UPDATEFederal Provider Number
145791
Provider Name
FIRESIDE HOUSE OF CENTRALIA
Provider Address
1030 MARTIN LUTHER KING BLVD
CENTRALIA, IL 62801
CENTRALIA, IL 62801
Provider Phone Number
6185321833
Provider SSA County
690
Provider County Name
Marion
Ownership Type
For profit - Corporation
Number of Certified Beds
98
Number of Residents in Certified Beds
90
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FIRESIDE-LTC, LLC
Date First Approved to Provide Medicare and Medicaid services
1994-05-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
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
3.45222
Reported LPN Staffing Hours per Resident per Day
1.15056
Reported RN Staffing Hours per Resident per Day
0.95222
Reported Licensed Staffing Hours per Resident per Day
2.10278
Reported Total Nurse Staffing Hours per Resident per Day
5.55500
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06333
Expected CNA Staffing Hours per Resident per Day
2.37615
Expected LPN Staffing Hours per Resident per Day
0.62412
Expected RN Staffing Hours per Resident per Day
0.95055
Expected Total Nurse Staffing Hours per Resident per Day
3.95082
Adjusted CNA Staffing Hours per Resident per Day
3.56488
Adjusted LPN Staffing Hours per Resident per Day
1.53011
Adjusted RN Staffing Hours per Resident per Day
0.74851
Adjusted Total Nurse Staffing Hours per Resident per Day
5.66759
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2015-01-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
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
4
Cycle 2 Standard Health Survey Date
2013-12-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-11-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
30.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
7
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
Nursiong Homes Nearby
Centralia Manor
1910 East Mccord Rte 161 East |
CENTRALIA IL 62801 | 1 mile away
Odin Health Care Center
300 Green Street |
ODIN IL 62870 | 7.3 miles away
Doctors Nursing And Rehab Center
1201 Hawthorn Road |
SALEM IL 62881 | 11.4 miles away
Twin Willows Nursing Center
1600 North Broadway, Po Box 370 |
SALEM IL 62881 | 12.3 miles away
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