Iroquois Resident Home, The - Watseka Nursing Home

General Information

UPDATE
Federal Provider Number
146049
Provider Name
IROQUOIS RESIDENT HOME, THE
Provider Address
200 FAIRMAN AVENUE
WATSEKA, IL 60970
Provider Phone Number
(815) 432-7768
Provider SSA County
460
Provider County Name
Iroquois
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
42
Number of Residents in Certified Beds
31
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME
Date First Approved to Provide Medicare and Medicaid services
2003-08-18
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
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
2.52097
Reported LPN Staffing Hours per Resident per Day
1.01290
Reported RN Staffing Hours per Resident per Day
1.21129
Reported Licensed Staffing Hours per Resident per Day
2.22419
Reported Total Nurse Staffing Hours per Resident per Day
4.74516
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05000
Expected CNA Staffing Hours per Resident per Day
2.53430
Expected LPN Staffing Hours per Resident per Day
0.73687
Expected RN Staffing Hours per Resident per Day
1.08755
Expected Total Nurse Staffing Hours per Resident per Day
4.35871
Adjusted CNA Staffing Hours per Resident per Day
2.44080
Adjusted LPN Staffing Hours per Resident per Day
1.14092
Adjusted RN Staffing Hours per Resident per Day
0.83222
Adjusted Total Nurse Staffing Hours per Resident per Day
4.38828
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2015-04-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
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
0
Cycle 2 Standard Health Survey Date
2014-05-08
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2013-07-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
26.00000
Number of Facility Reported Incidents
0
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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