Montebello Healthcare Center - Hamilton Nursing Home
General Information
UPDATEFederal Provider Number
145471
Provider Name
MONTEBELLO HEALTHCARE CENTER
Provider Address
1599 KEOKUK STREET
HAMILTON, IL 62341
HAMILTON, IL 62341
Provider Phone Number
(217) 847-3931
Provider SSA County
420
Provider County Name
Hancock
Provider Website
Provider Description
Ownership Type
For profit - Limited Liability
Number of Certified Beds
139
Number of Residents in Certified Beds
73
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SSC HAMILTON OPERATING COMPANY LLC
Date First Approved to Provide Medicare and Medicaid services
1983-08-16
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
1.66575
Reported LPN Staffing Hours per Resident per Day
0.48630
Reported RN Staffing Hours per Resident per Day
0.78767
Reported Licensed Staffing Hours per Resident per Day
1.27397
Reported Total Nurse Staffing Hours per Resident per Day
2.93972
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01575
Expected CNA Staffing Hours per Resident per Day
2.34775
Expected LPN Staffing Hours per Resident per Day
0.58409
Expected RN Staffing Hours per Resident per Day
0.82703
Expected Total Nurse Staffing Hours per Resident per Day
3.75887
Adjusted CNA Staffing Hours per Resident per Day
1.74092
Adjusted LPN Staffing Hours per Resident per Day
0.69104
Adjusted RN Staffing Hours per Resident per Day
0.71164
Adjusted Total Nurse Staffing Hours per Resident per Day
3.15246
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-09-19
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-08-22
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
6
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2012-10-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
27.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
3
Number of Fines
1
Total Amount of Fines in Dollars
3250
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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