Lutheran Home, The - Peoria Nursing Home

General Information

UPDATE
Federal Provider Number
145768
Provider Name
LUTHERAN HOME, THE
Provider Address
6901 NORTH GALENA ROAD
PEORIA, IL 61614
Provider Phone Number
3096831264
Provider SSA County
800
Provider County Name
Peoria
Ownership Type
Non profit - Church related
Number of Certified Beds
85
Number of Residents in Certified Beds
73
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LUTHERAN HILLSIDE VILLAGE INC
Date First Approved to Provide Medicare and Medicaid services
1994-01-01
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
5
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
2.85548
Reported LPN Staffing Hours per Resident per Day
1.13288
Reported RN Staffing Hours per Resident per Day
0.85890
Reported Licensed Staffing Hours per Resident per Day
1.99178
Reported Total Nurse Staffing Hours per Resident per Day
4.84726
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08425
Expected CNA Staffing Hours per Resident per Day
2.41087
Expected LPN Staffing Hours per Resident per Day
0.53260
Expected RN Staffing Hours per Resident per Day
0.86657
Expected Total Nurse Staffing Hours per Resident per Day
3.81005
Adjusted CNA Staffing Hours per Resident per Day
2.90621
Adjusted LPN Staffing Hours per Resident per Day
1.76546
Adjusted RN Staffing Hours per Resident per Day
0.74058
Adjusted Total Nurse Staffing Hours per Resident per Day
5.12823
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
13
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2015-01-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
80
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2014-04-04
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
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2013-03-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
51.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
3
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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