Jacksonville Skilled Nursing & Rehab - Jacksonville Nursing Home
General Information
UPDATEFederal Provider Number
145273
Provider Name
JACKSONVILLE SKILLED NURSING & REHAB
Provider Address
1517 WEST WALNUT STREET
JACKSONVILLE, IL 62650
JACKSONVILLE, IL 62650
Provider Phone Number
(217) 243-6451
Provider SSA County
770
Provider County Name
Morgan
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
88
Number of Residents in Certified Beds
85
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COVENANT CARE JACKSONVILLE, LLC
Date First Approved to Provide Medicare and Medicaid services
1974-09-04
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
2
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
1.99647
Reported LPN Staffing Hours per Resident per Day
0.72706
Reported RN Staffing Hours per Resident per Day
0.59941
Reported Licensed Staffing Hours per Resident per Day
1.32647
Reported Total Nurse Staffing Hours per Resident per Day
3.32294
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06824
Expected CNA Staffing Hours per Resident per Day
2.61709
Expected LPN Staffing Hours per Resident per Day
0.62911
Expected RN Staffing Hours per Resident per Day
0.99184
Expected Total Nurse Staffing Hours per Resident per Day
4.23803
Adjusted CNA Staffing Hours per Resident per Day
1.87183
Adjusted LPN Staffing Hours per Resident per Day
0.95922
Adjusted RN Staffing Hours per Resident per Day
0.45157
Adjusted Total Nurse Staffing Hours per Resident per Day
3.16053
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
28
Cycle 1 Standard Survey Health Date
2015-04-24
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2014-05-15
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
8
Cycle 3 Standard Health Survey Date
2013-06-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
26.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
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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