Heritage Health-jacksonville - Jacksonville Nursing Home
General Information
UPDATEFederal Provider Number
146059
Provider Name
HERITAGE HEALTH-JACKSONVILLE
Provider Address
873 GROVE STREET
JACKSONVILLE, IL 62650
JACKSONVILLE, IL 62650
Provider Phone Number
(217) 479-3400
Provider SSA County
770
Provider County Name
Morgan
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
185
Number of Residents in Certified Beds
151
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BARTON W. STONE - JACKSONVILLE, L.L.C.
Date First Approved to Provide Medicare and Medicaid services
2004-04-19
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
5
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
2.39636
Reported LPN Staffing Hours per Resident per Day
0.72152
Reported RN Staffing Hours per Resident per Day
0.54106
Reported Licensed Staffing Hours per Resident per Day
1.26258
Reported Total Nurse Staffing Hours per Resident per Day
3.65894
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03974
Expected CNA Staffing Hours per Resident per Day
2.43167
Expected LPN Staffing Hours per Resident per Day
0.57030
Expected RN Staffing Hours per Resident per Day
0.92703
Expected Total Nurse Staffing Hours per Resident per Day
3.92900
Adjusted CNA Staffing Hours per Resident per Day
2.41807
Adjusted LPN Staffing Hours per Resident per Day
1.05008
Adjusted RN Staffing Hours per Resident per Day
0.43610
Adjusted Total Nurse Staffing Hours per Resident per Day
3.75384
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-07-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-06-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
91
Cycle 3 Standard Health Survey Date
2012-08-24
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
91
Total Weighted Health Survey Score
33.16700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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