Mar Ka Nursing Home - Mascoutah Nursing Home
General Information
UPDATEFederal Provider Number
145518
Provider Name
MAR KA NURSING HOME
Provider Address
201 SOUTH 10TH STREET
MASCOUTAH, IL 62258
MASCOUTAH, IL 62258
Provider Phone Number
6185668000
Provider SSA County
900
Provider County Name
St. Clair
Ownership Type
For profit - Individual
Number of Certified Beds
76
Number of Residents in Certified Beds
54
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COMMUNITY CARE CENTER OF MASCOUTAH, INC.
Date First Approved to Provide Medicare and Medicaid services
1985-03-15
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.22778
Reported LPN Staffing Hours per Resident per Day
0.82870
Reported RN Staffing Hours per Resident per Day
0.70000
Reported Licensed Staffing Hours per Resident per Day
1.52870
Reported Total Nurse Staffing Hours per Resident per Day
3.75648
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01944
Expected CNA Staffing Hours per Resident per Day
2.53820
Expected LPN Staffing Hours per Resident per Day
0.59068
Expected RN Staffing Hours per Resident per Day
0.87891
Expected Total Nurse Staffing Hours per Resident per Day
4.00778
Adjusted CNA Staffing Hours per Resident per Day
2.15362
Adjusted LPN Staffing Hours per Resident per Day
1.16446
Adjusted RN Staffing Hours per Resident per Day
0.59510
Adjusted Total Nurse Staffing Hours per Resident per Day
3.77815
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-06-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
182
Cycle 2 Standard Health Survey Date
2013-07-18
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
2
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-08-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
100.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
1
Total Amount of Fines in Dollars
6305
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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