Mattoon Rehab & Hcc - Mattoon Nursing Home
General Information
UPDATEFederal Provider Number
145480
Provider Name
MATTOON REHAB & HCC
Provider Address
2121 SOUTH NINTH
MATTOON, IL 61938
MATTOON, IL 61938
Provider Phone Number
(217) 235-7138
Provider SSA County
140
Provider County Name
Coles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
148
Number of Residents in Certified Beds
86
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MATTOON MANOR, LLC
Date First Approved to Provide Medicare and Medicaid services
1983-09-14
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.20058
Reported LPN Staffing Hours per Resident per Day
0.72849
Reported RN Staffing Hours per Resident per Day
0.51047
Reported Licensed Staffing Hours per Resident per Day
1.23895
Reported Total Nurse Staffing Hours per Resident per Day
3.43954
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06628
Expected CNA Staffing Hours per Resident per Day
2.26243
Expected LPN Staffing Hours per Resident per Day
0.68296
Expected RN Staffing Hours per Resident per Day
1.10253
Expected Total Nurse Staffing Hours per Resident per Day
4.04792
Adjusted CNA Staffing Hours per Resident per Day
2.38662
Adjusted LPN Staffing Hours per Resident per Day
0.88533
Adjusted RN Staffing Hours per Resident per Day
0.34595
Adjusted Total Nurse Staffing Hours per Resident per Day
3.42508
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-07-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-08-23
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2012-09-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
45.33300
Number of Facility Reported Incidents
1
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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