Palm Terrace Of Mattoon - Mattoon Nursing Home
General Information
UPDATEFederal Provider Number
145584
Provider Name
PALM TERRACE OF MATTOON
Provider Address
1000 PALM
MATTOON, IL 61938
MATTOON, IL 61938
Provider Phone Number
(217) 234-7403
Provider SSA County
140
Provider County Name
Coles
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
178
Number of Residents in Certified Beds
129
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PETERSEN MANAGEMENT COMPANY, LLC
Date First Approved to Provide Medicare and Medicaid services
1987-10-14
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
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
2.03333
Reported LPN Staffing Hours per Resident per Day
0.58295
Reported RN Staffing Hours per Resident per Day
0.54612
Reported Licensed Staffing Hours per Resident per Day
1.12907
Reported Total Nurse Staffing Hours per Resident per Day
3.16240
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01899
Expected CNA Staffing Hours per Resident per Day
1.95806
Expected LPN Staffing Hours per Resident per Day
0.54045
Expected RN Staffing Hours per Resident per Day
0.78283
Expected Total Nurse Staffing Hours per Resident per Day
3.28134
Adjusted CNA Staffing Hours per Resident per Day
2.54803
Adjusted LPN Staffing Hours per Resident per Day
0.89526
Adjusted RN Staffing Hours per Resident per Day
0.52126
Adjusted Total Nurse Staffing Hours per Resident per Day
3.88479
Cycle 1 Total Number of Health Deficiencies
17
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
8
Cycle 1 Health Deficiency Score
160
Cycle 1 Standard Survey Health Date
2015-02-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
160
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
72
Cycle 2 Standard Health Survey Date
2014-01-17
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
72
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
24
Cycle 3 Standard Health Survey Date
2013-04-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
108.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
7
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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