Heritage Health-chillicothe - Chillicothe Nursing Home

General Information

UPDATE
Federal Provider Number
145058
Provider Name
HERITAGE HEALTH-CHILLICOTHE
Provider Address
1028 HILLCREST DRIVE
CHILLICOTHE, IL 61523
Provider Phone Number
3092742194
Provider SSA County
800
Provider County Name
Peoria
Ownership Type
For profit - Corporation
Number of Certified Beds
110
Number of Residents in Certified Beds
93
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HERITAGE MANOR - CHILLICOTHE. 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
3
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
2.11129
Reported LPN Staffing Hours per Resident per Day
0.78172
Reported RN Staffing Hours per Resident per Day
0.58172
Reported Licensed Staffing Hours per Resident per Day
1.36344
Reported Total Nurse Staffing Hours per Resident per Day
3.47473
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01129
Expected CNA Staffing Hours per Resident per Day
2.49043
Expected LPN Staffing Hours per Resident per Day
0.61438
Expected RN Staffing Hours per Resident per Day
1.00346
Expected Total Nurse Staffing Hours per Resident per Day
4.10828
Adjusted CNA Staffing Hours per Resident per Day
2.08015
Adjusted LPN Staffing Hours per Resident per Day
1.05607
Adjusted RN Staffing Hours per Resident per Day
0.43316
Adjusted Total Nurse Staffing Hours per Resident per Day
3.40929
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-11-20
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
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2014-01-10
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
2013-02-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
26.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
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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