Presence Heritage Village - Kankakee Nursing Home
General Information
UPDATEFederal Provider Number
146056
Provider Name
PRESENCE HERITAGE VILLAGE
Provider Address
901 NORTH ENTRANCE AVENUE
KANKAKEE, IL 60901
KANKAKEE, IL 60901
Provider Phone Number
(815) 939-4506
Provider SSA County
540
Provider County Name
Kankakee
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
51
Number of Residents in Certified Beds
32
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
PRESENCE LIFE CONNECTIONS
Date First Approved to Provide Medicare and Medicaid services
2003-12-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
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
2.98906
Reported LPN Staffing Hours per Resident per Day
1.41250
Reported RN Staffing Hours per Resident per Day
1.13750
Reported Licensed Staffing Hours per Resident per Day
2.55000
Reported Total Nurse Staffing Hours per Resident per Day
5.53906
Reported Physical Therapist Staffing Hours per Resident Per Day
0.13594
Expected CNA Staffing Hours per Resident per Day
2.19132
Expected LPN Staffing Hours per Resident per Day
0.62773
Expected RN Staffing Hours per Resident per Day
1.29413
Expected Total Nurse Staffing Hours per Resident per Day
4.11318
Adjusted CNA Staffing Hours per Resident per Day
3.34696
Adjusted LPN Staffing Hours per Resident per Day
1.86763
Adjusted RN Staffing Hours per Resident per Day
0.65676
Adjusted Total Nurse Staffing Hours per Resident per Day
5.42825
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2015-04-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2014-05-08
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
76
Cycle 3 Standard Health Survey Date
2013-03-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
76
Total Weighted Health Survey Score
25.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
8
Number of Fines
1
Total Amount of Fines in Dollars
7963
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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