Heritage Health-bloomington - Bloomington Nursing Home
General Information
Update InformationReport Incorrect Information
Federal Provider Number
145016
Provider Name
HERITAGE HEALTH-BLOOMINGTON
Provider Address
700 EAST WALNUT
BLOOMINGTON, IL 61701
BLOOMINGTON, IL 61701
Provider Phone Number
(309) 827-8004
Provider SSA County
650
Provider County Name
Mc Lean
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
111
Number of Residents in Certified Beds
64
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HERITAGE MANOR - BLOOMINGTON, LLC
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
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
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
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
2.41484
Reported LPN Staffing Hours per Resident per Day
0.65859
Reported RN Staffing Hours per Resident per Day
1.27500
Reported Licensed Staffing Hours per Resident per Day
1.93359
Reported Total Nurse Staffing Hours per Resident per Day
4.34843
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04922
Expected CNA Staffing Hours per Resident per Day
2.48756
Expected LPN Staffing Hours per Resident per Day
0.61725
Expected RN Staffing Hours per Resident per Day
1.11795
Expected Total Nurse Staffing Hours per Resident per Day
4.22275
Adjusted CNA Staffing Hours per Resident per Day
2.38197
Adjusted LPN Staffing Hours per Resident per Day
0.88559
Adjusted RN Staffing Hours per Resident per Day
0.85217
Adjusted Total Nurse Staffing Hours per Resident per Day
4.15087
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
24
Cycle 1 Standard Survey Health Date
2014-10-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-12-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2013-02-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
26.00000
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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