Forest City Rehab & Nrsg Ctr - Rockford Nursing Home
General Information
UPDATEFederal Provider Number
145937
Provider Name
FOREST CITY REHAB & NRSG CTR
Provider Address
321 ARNOLD AVENUE
ROCKFORD, IL 61108
ROCKFORD, IL 61108
Provider Phone Number
(815) 397-5531
Provider SSA County
991
Provider County Name
Winnebago
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
213
Number of Residents in Certified Beds
193
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FOREST CITY REHAB AND NURSING CENTER LLC
Date First Approved to Provide Medicare and Medicaid services
1997-07-01
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
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.40000
Reported LPN Staffing Hours per Resident per Day
0.51114
Reported RN Staffing Hours per Resident per Day
0.20440
Reported Licensed Staffing Hours per Resident per Day
0.71554
Reported Total Nurse Staffing Hours per Resident per Day
2.11554
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
1.82797
Expected LPN Staffing Hours per Resident per Day
0.51561
Expected RN Staffing Hours per Resident per Day
0.76289
Expected Total Nurse Staffing Hours per Resident per Day
3.10647
Adjusted CNA Staffing Hours per Resident per Day
1.87923
Adjusted LPN Staffing Hours per Resident per Day
0.82280
Adjusted RN Staffing Hours per Resident per Day
0.20020
Adjusted Total Nurse Staffing Hours per Resident per Day
2.74509
Cycle 1 Total Number of Health Deficiencies
27
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
18
Cycle 1 Health Deficiency Score
152
Cycle 1 Standard Survey Health Date
2015-01-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
152
Cycle 2 Total Number of Health Deficiencies
21
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
12
Cycle 2 Health Deficiency Score
233
Cycle 2 Standard Health Survey Date
2013-11-22
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
233
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2013-01-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
159.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
25
Number of Fines
1
Total Amount of Fines in Dollars
33833
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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