Good Samaritan - Flanagan - Flanagan Nursing Home
General Information
UPDATEFederal Provider Number
146089
Provider Name
GOOD SAMARITAN - FLANAGAN
Provider Address
205 NORTH ADAMS
FLANAGAN, IL 61740
FLANAGAN, IL 61740
Provider Phone Number
(815) 796-2288
Provider SSA County
610
Provider County Name
Livingston
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
60
Number of Residents in Certified Beds
49
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GOOD SAMARITAN - FLANAGAN
Date First Approved to Provide Medicare and Medicaid services
2005-10-01
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.14388
Reported LPN Staffing Hours per Resident per Day
0.55102
Reported RN Staffing Hours per Resident per Day
0.49388
Reported Licensed Staffing Hours per Resident per Day
1.04490
Reported Total Nurse Staffing Hours per Resident per Day
3.18878
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08163
Expected CNA Staffing Hours per Resident per Day
2.38830
Expected LPN Staffing Hours per Resident per Day
0.57826
Expected RN Staffing Hours per Resident per Day
0.90904
Expected Total Nurse Staffing Hours per Resident per Day
3.87560
Adjusted CNA Staffing Hours per Resident per Day
2.20258
Adjusted LPN Staffing Hours per Resident per Day
0.79091
Adjusted RN Staffing Hours per Resident per Day
0.40595
Adjusted Total Nurse Staffing Hours per Resident per Day
3.31656
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
32
Cycle 1 Standard Survey Health Date
2014-06-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-04-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-05-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
34.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
975
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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