Roseville Rehab & Health Care - Roseville Nursing Home
General Information
UPDATEFederal Provider Number
146020
Provider Name
ROSEVILLE REHAB & HEALTH CARE
Provider Address
145 S CHAMBERLAIN ST, BOX 770
ROSEVILLE, IL 61473
ROSEVILLE, IL 61473
Provider Phone Number
(309) 426-2134
Provider SSA County
984
Provider County Name
Warren
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
99
Number of Residents in Certified Beds
54
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PETERSEN HEALTH CARE ROSEVILLE LLC
Date First Approved to Provide Medicare and Medicaid services
2002-04-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.91019
Reported LPN Staffing Hours per Resident per Day
0.57778
Reported RN Staffing Hours per Resident per Day
0.50185
Reported Licensed Staffing Hours per Resident per Day
1.07963
Reported Total Nurse Staffing Hours per Resident per Day
2.98982
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10556
Expected CNA Staffing Hours per Resident per Day
2.26538
Expected LPN Staffing Hours per Resident per Day
0.60693
Expected RN Staffing Hours per Resident per Day
0.98307
Expected Total Nurse Staffing Hours per Resident per Day
3.85538
Adjusted CNA Staffing Hours per Resident per Day
2.06899
Adjusted LPN Staffing Hours per Resident per Day
0.79014
Adjusted RN Staffing Hours per Resident per Day
0.38144
Adjusted Total Nurse Staffing Hours per Resident per Day
3.12594
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2015-03-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
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
2014-05-22
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2013-04-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
28.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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