Leroy Manor - Le Roy Nursing Home
General Information
UPDATEFederal Provider Number
145674
Provider Name
LEROY MANOR
Provider Address
509 SOUTH BUCK ROAD, PO BOX 149
LE ROY, IL 61752
LE ROY, IL 61752
Provider Phone Number
(309) 962-5000
Provider SSA County
650
Provider County Name
Mc Lean
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
102
Number of Residents in Certified Beds
66
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
UNLIMITED DEVELOPMENT, INC
Date First Approved to Provide Medicare and Medicaid services
1989-12-18
Continuing Care Retirement Community
Y
Special Focus Facility
Y
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
1
Overall Rating Footnote
Health Inspection Rating
1
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
2.76061
Reported LPN Staffing Hours per Resident per Day
0.82273
Reported RN Staffing Hours per Resident per Day
0.46894
Reported Licensed Staffing Hours per Resident per Day
1.29167
Reported Total Nurse Staffing Hours per Resident per Day
4.05228
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07955
Expected CNA Staffing Hours per Resident per Day
2.59918
Expected LPN Staffing Hours per Resident per Day
0.59995
Expected RN Staffing Hours per Resident per Day
0.88450
Expected Total Nurse Staffing Hours per Resident per Day
4.08362
Adjusted CNA Staffing Hours per Resident per Day
2.60610
Adjusted LPN Staffing Hours per Resident per Day
1.13820
Adjusted RN Staffing Hours per Resident per Day
0.39615
Adjusted Total Nurse Staffing Hours per Resident per Day
3.99996
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2015-03-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
569
Cycle 2 Standard Health Survey Date
2014-09-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
569
Cycle 3 Total Number of Health Deficiencies
23
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
15
Cycle 3 Health Deficiency Score
357
Cycle 3 Standard Health Survey Date
2014-05-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
357
Total Weighted Health Survey Score
263.16700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
20
Number of Fines
4
Total Amount of Fines in Dollars
130475
Number of Payment Denials
0
Total Number of Penalties
4
Location
Processing Date
2015-06-01
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