Shawnee Christian Nursing Ctr - Herrin Nursing Home
General Information
UPDATEFederal Provider Number
146036
Provider Name
SHAWNEE CHRISTIAN NURSING CTR
Provider Address
1901 13TH STREET
HERRIN, IL 62948
HERRIN, IL 62948
Provider Phone Number
(618) 942-7391
Provider SSA County
990
Provider County Name
Williamson
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
159
Number of Residents in Certified Beds
128
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SHAWNEE CHRISTIAN NURSING CENTER, LLC
Date First Approved to Provide Medicare and Medicaid services
2002-11-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.06914
Reported LPN Staffing Hours per Resident per Day
0.75547
Reported RN Staffing Hours per Resident per Day
0.34063
Reported Licensed Staffing Hours per Resident per Day
1.09609
Reported Total Nurse Staffing Hours per Resident per Day
3.16524
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14023
Expected CNA Staffing Hours per Resident per Day
2.46640
Expected LPN Staffing Hours per Resident per Day
0.67047
Expected RN Staffing Hours per Resident per Day
1.04435
Expected Total Nurse Staffing Hours per Resident per Day
4.18121
Adjusted CNA Staffing Hours per Resident per Day
2.05849
Adjusted LPN Staffing Hours per Resident per Day
0.93523
Adjusted RN Staffing Hours per Resident per Day
0.24371
Adjusted Total Nurse Staffing Hours per Resident per Day
3.05145
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
60
Cycle 1 Standard Survey Health Date
2014-06-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
60
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
151
Cycle 2 Standard Health Survey Date
2013-07-19
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
76
Cycle 2 Total Health Score
227
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
10
Cycle 3 Health Deficiency Score
369
Cycle 3 Standard Health Survey Date
2012-08-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
369
Total Weighted Health Survey Score
167.16700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
20
Number of Fines
4
Total Amount of Fines in Dollars
162890
Number of Payment Denials
1
Total Number of Penalties
5
Location
Processing Date
2015-06-01
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