Pinecrest Manor - Mount Morris Nursing Home
General Information
UPDATEFederal Provider Number
145024
Provider Name
PINECREST MANOR
Provider Address
414 SOUTH WESLEY AVENUE
MOUNT MORRIS, IL 61054
MOUNT MORRIS, IL 61054
Provider Phone Number
8157344103
Provider SSA County
790
Provider County Name
Ogle
Ownership Type
Non profit - Church related
Number of Certified Beds
125
Number of Residents in Certified Beds
103
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BRETHREN HOME
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
Continuing Care Retirement Community
Y
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
4
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
2.30291
Reported LPN Staffing Hours per Resident per Day
0.41602
Reported RN Staffing Hours per Resident per Day
0.93981
Reported Licensed Staffing Hours per Resident per Day
1.35583
Reported Total Nurse Staffing Hours per Resident per Day
3.65874
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09272
Expected CNA Staffing Hours per Resident per Day
2.20602
Expected LPN Staffing Hours per Resident per Day
0.54922
Expected RN Staffing Hours per Resident per Day
0.77119
Expected Total Nurse Staffing Hours per Resident per Day
3.52643
Adjusted CNA Staffing Hours per Resident per Day
2.56147
Adjusted LPN Staffing Hours per Resident per Day
0.62871
Adjusted RN Staffing Hours per Resident per Day
0.91057
Adjusted Total Nurse Staffing Hours per Resident per Day
4.18214
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2015-04-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2014-03-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2013-02-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
14.66700
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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