Illinois Nursing Homes >> Mendon Nursing Homes >> North Adams Home

North Adams Home - Mendon Nursing Home

General Information

UPDATE
Federal Provider Number
146035
Provider Name
NORTH ADAMS HOME
Provider Address
2259 EAST 1100TH STREET
MENDON, IL 62351
Provider Phone Number
(217) 936-2137
Provider SSA County
0
Provider County Name
Adams
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
92
Number of Residents in Certified Beds
52
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
NORTH ADAMS HOME
Date First Approved to Provide Medicare and Medicaid services
2002-10-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
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
2.10288
Reported LPN Staffing Hours per Resident per Day
0.66731
Reported RN Staffing Hours per Resident per Day
1.12885
Reported Licensed Staffing Hours per Resident per Day
1.79615
Reported Total Nurse Staffing Hours per Resident per Day
3.89904
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08654
Expected CNA Staffing Hours per Resident per Day
2.28780
Expected LPN Staffing Hours per Resident per Day
0.62937
Expected RN Staffing Hours per Resident per Day
0.96424
Expected Total Nurse Staffing Hours per Resident per Day
3.88141
Adjusted CNA Staffing Hours per Resident per Day
2.25537
Adjusted LPN Staffing Hours per Resident per Day
0.88003
Adjusted RN Staffing Hours per Resident per Day
0.87476
Adjusted Total Nurse Staffing Hours per Resident per Day
4.04921
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2015-03-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2014-06-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
52
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2013-04-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
28.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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