Prairie Crossing Lvg & Rehab - Shabbona Nursing Home
General Information
UPDATEFederal Provider Number
145414
Provider Name
PRAIRIE CROSSING LVG & REHAB
Provider Address
409 WEST COMANCHE ROAD
SHABBONA, IL 60550
SHABBONA, IL 60550
Provider Phone Number
(815) 824-2194
Provider SSA County
170
Provider County Name
De Kalb
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
91
Number of Residents in Certified Beds
69
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PRAIRIE CROSSING LIVING & REHABILITATION CENTER LLC
Date First Approved to Provide Medicare and Medicaid services
1980-10-01
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
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
2.19058
Reported LPN Staffing Hours per Resident per Day
0.37826
Reported RN Staffing Hours per Resident per Day
0.61377
Reported Licensed Staffing Hours per Resident per Day
0.99203
Reported Total Nurse Staffing Hours per Resident per Day
3.18261
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01739
Expected CNA Staffing Hours per Resident per Day
2.60312
Expected LPN Staffing Hours per Resident per Day
0.56287
Expected RN Staffing Hours per Resident per Day
0.81990
Expected Total Nurse Staffing Hours per Resident per Day
3.98589
Adjusted CNA Staffing Hours per Resident per Day
2.06484
Adjusted LPN Staffing Hours per Resident per Day
0.55777
Adjusted RN Staffing Hours per Resident per Day
0.55935
Adjusted Total Nurse Staffing Hours per Resident per Day
3.21855
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-11-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-10-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
16
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
9
Cycle 3 Health Deficiency Score
96
Cycle 3 Standard Health Survey Date
2013-03-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
96
Total Weighted Health Survey Score
60.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
11
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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