Proctor Com Hsp Sk N Center - Peoria Nursing Home
General Information
UPDATEFederal Provider Number
145579
Provider Name
PROCTOR COM HSP SK N CENTER
Provider Address
5409 NORTH KNOXVILLE AVENUE
PEORIA, IL 61614
PEORIA, IL 61614
Provider Phone Number
(309) 691-1000
Provider SSA County
800
Provider County Name
Peoria
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
36
Number of Residents in Certified Beds
19
Provider Type
Medicare
Provider Resides in Hospital
Y
Legal Business Name
PROCTOR COMMUNITY HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1987-11-03
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
4
QM Rating Footnote
Staffing Rating
5
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
1.43684
Reported LPN Staffing Hours per Resident per Day
0.50000
Reported RN Staffing Hours per Resident per Day
4.22368
Reported Licensed Staffing Hours per Resident per Day
4.72368
Reported Total Nurse Staffing Hours per Resident per Day
6.16052
Reported Physical Therapist Staffing Hours per Resident Per Day
0.33947
Expected CNA Staffing Hours per Resident per Day
2.36265
Expected LPN Staffing Hours per Resident per Day
0.90376
Expected RN Staffing Hours per Resident per Day
1.94521
Expected Total Nurse Staffing Hours per Resident per Day
5.21162
Adjusted CNA Staffing Hours per Resident per Day
1.49221
Adjusted LPN Staffing Hours per Resident per Day
0.45919
Adjusted RN Staffing Hours per Resident per Day
1.62241
Adjusted Total Nurse Staffing Hours per Resident per Day
4.76482
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-10-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-11-13
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-09-26
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
20.00000
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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