Monmouth Nursing Home - Monmouth Nursing Home
General Information
UPDATEFederal Provider Number
146057
Provider Name
MONMOUTH NURSING HOME
Provider Address
117 SOUTH I STREET
MONMOUTH, IL 61462
MONMOUTH, IL 61462
Provider Phone Number
(309) 734-3811
Provider SSA County
984
Provider County Name
Warren
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
59
Number of Residents in Certified Beds
49
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COMMUNITY CARE CENTER OF MONMOUTH
Date First Approved to Provide Medicare and Medicaid services
2003-12-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Family
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
4
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
2.61224
Reported LPN Staffing Hours per Resident per Day
0.90918
Reported RN Staffing Hours per Resident per Day
0.52449
Reported Licensed Staffing Hours per Resident per Day
1.43367
Reported Total Nurse Staffing Hours per Resident per Day
4.04591
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02347
Expected CNA Staffing Hours per Resident per Day
2.29372
Expected LPN Staffing Hours per Resident per Day
0.57365
Expected RN Staffing Hours per Resident per Day
0.84103
Expected Total Nurse Staffing Hours per Resident per Day
3.70840
Adjusted CNA Staffing Hours per Resident per Day
2.79444
Adjusted LPN Staffing Hours per Resident per Day
1.31546
Adjusted RN Staffing Hours per Resident per Day
0.46598
Adjusted Total Nurse Staffing Hours per Resident per Day
4.39776
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-10-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-11-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-12-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
32.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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