Royal Oaks Care Center - Kewanee Nursing Home
General Information
UPDATEFederal Provider Number
145418
Provider Name
ROYAL OAKS CARE CENTER
Provider Address
605 EAST CHURCH STREET, P O BOX 600
KEWANEE, IL 61443
KEWANEE, IL 61443
Provider Phone Number
(309) 852-3389
Provider SSA County
450
Provider County Name
Henry
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
200
Number of Residents in Certified Beds
132
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PETERSEN HEALTH CARE II INC
Date First Approved to Provide Medicare and Medicaid services
1981-02-08
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
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
2.00227
Reported LPN Staffing Hours per Resident per Day
0.87689
Reported RN Staffing Hours per Resident per Day
0.58750
Reported Licensed Staffing Hours per Resident per Day
1.46439
Reported Total Nurse Staffing Hours per Resident per Day
3.46666
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02159
Expected CNA Staffing Hours per Resident per Day
1.87697
Expected LPN Staffing Hours per Resident per Day
0.56537
Expected RN Staffing Hours per Resident per Day
0.78545
Expected Total Nurse Staffing Hours per Resident per Day
3.22780
Adjusted CNA Staffing Hours per Resident per Day
2.61749
Adjusted LPN Staffing Hours per Resident per Day
1.28733
Adjusted RN Staffing Hours per Resident per Day
0.55889
Adjusted Total Nurse Staffing Hours per Resident per Day
4.32919
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
92
Cycle 1 Standard Survey Health Date
2014-08-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
92
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-10-24
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-09-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
50.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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