Illinois Nursing Homes >> Golden Nursing Homes >> Golden Good Shepherd Home

Golden Good Shepherd Home - Golden Nursing Home

General Information

UPDATE
Federal Provider Number
146111
Provider Name
GOLDEN GOOD SHEPHERD HOME
Provider Address
101 PRAIRIE MILLS ROAD
GOLDEN, IL 62339
Provider Phone Number
2176964421
Provider SSA County
0
Provider County Name
Adams
Ownership Type
Non profit - Corporation
Number of Certified Beds
46
Number of Residents in Certified Beds
40
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GOLDEN GOOD SHEPHERD HOME
Date First Approved to Provide Medicare and Medicaid services
2007-07-01
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
3
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
2.62500
Reported LPN Staffing Hours per Resident per Day
0.86000
Reported RN Staffing Hours per Resident per Day
0.68375
Reported Licensed Staffing Hours per Resident per Day
1.54375
Reported Total Nurse Staffing Hours per Resident per Day
4.16875
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00125
Expected CNA Staffing Hours per Resident per Day
2.17502
Expected LPN Staffing Hours per Resident per Day
0.59068
Expected RN Staffing Hours per Resident per Day
0.79874
Expected Total Nurse Staffing Hours per Resident per Day
3.56445
Adjusted CNA Staffing Hours per Resident per Day
2.96133
Adjusted LPN Staffing Hours per Resident per Day
1.20843
Adjusted RN Staffing Hours per Resident per Day
0.63963
Adjusted Total Nurse Staffing Hours per Resident per Day
4.71428
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
36
Cycle 1 Standard Survey Health Date
2014-09-26
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
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-10-21
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-11-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
30.00000
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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