Prairie View Cr Ctr-lewistown - Lewistown Nursing Home

General Information

UPDATE
Federal Provider Number
145900
Provider Name
PRAIRIE VIEW CR CTR-LEWISTOWN
Provider Address
175 EAST SYCAMORE
LEWISTOWN, IL 61542
Provider Phone Number
3095472267
Provider SSA County
370
Provider County Name
Fulton
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
74
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PRAIRIE VIEW CARE CENTER OF LEWISTOWN, INC
Date First Approved to Provide Medicare and Medicaid services
1996-09-29
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
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
1.71486
Reported LPN Staffing Hours per Resident per Day
0.44189
Reported RN Staffing Hours per Resident per Day
1.34932
Reported Licensed Staffing Hours per Resident per Day
1.79122
Reported Total Nurse Staffing Hours per Resident per Day
3.50607
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07703
Expected CNA Staffing Hours per Resident per Day
2.81608
Expected LPN Staffing Hours per Resident per Day
0.71987
Expected RN Staffing Hours per Resident per Day
0.94190
Expected Total Nurse Staffing Hours per Resident per Day
4.47785
Adjusted CNA Staffing Hours per Resident per Day
1.49419
Adjusted LPN Staffing Hours per Resident per Day
0.50949
Adjusted RN Staffing Hours per Resident per Day
1.07040
Adjusted Total Nurse Staffing Hours per Resident per Day
3.15612
Cycle 1 Total Number of Health Deficiencies
22
Cycle 1 Number of Standard Health Deficiencies
16
Cycle 1 Number of Complaint Health Deficiencies
6
Cycle 1 Health Deficiency Score
1114
Cycle 1 Standard Survey Health Date
2014-08-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
1114
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-07-11
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
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2012-08-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
568.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
8
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
1
Total Number of Penalties
1
Location
Processing Date
2015-06-01

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