Odd Fellow-rebekah Home - Mattoon Nursing Home
General Information
UPDATEFederal Provider Number
145772
Provider Name
ODD FELLOW-REBEKAH HOME
Provider Address
201 LAFAYETTE AVENUE EAST
MATTOON, IL 61938
MATTOON, IL 61938
Provider Phone Number
(217) 235-5449
Provider SSA County
140
Provider County Name
Coles
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
162
Number of Residents in Certified Beds
124
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
INDEPENDENT ORDER OF ODD FELLOWS
Date First Approved to Provide Medicare and Medicaid services
1993-11-16
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
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
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.35565
Reported LPN Staffing Hours per Resident per Day
0.57339
Reported RN Staffing Hours per Resident per Day
0.78145
Reported Licensed Staffing Hours per Resident per Day
1.35484
Reported Total Nurse Staffing Hours per Resident per Day
3.71049
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01734
Expected CNA Staffing Hours per Resident per Day
2.30323
Expected LPN Staffing Hours per Resident per Day
0.54408
Expected RN Staffing Hours per Resident per Day
0.86510
Expected Total Nurse Staffing Hours per Resident per Day
3.71240
Adjusted CNA Staffing Hours per Resident per Day
2.50954
Adjusted LPN Staffing Hours per Resident per Day
0.87472
Adjusted RN Staffing Hours per Resident per Day
0.67495
Adjusted Total Nurse Staffing Hours per Resident per Day
4.02882
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-12-05
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
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
4
Cycle 2 Standard Health Survey Date
2014-02-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2013-01-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
23.33300
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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