St John Hospital Ltc Unit - Springfield Nursing Home
General Information
UPDATEFederal Provider Number
145225
Provider Name
ST JOHN HOSPITAL LTC UNIT
Provider Address
800 EAST CARPENTER, 11TH FLOOR
SPRINGFIELD, IL 62702
SPRINGFIELD, IL 62702
Provider Phone Number
(217) 544-6464
Provider SSA County
920
Provider County Name
Sangamon
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
37
Number of Residents in Certified Beds
26
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
ST. JOHN'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST F
Date First Approved to Provide Medicare and Medicaid services
1977-06-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
1
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
2.83462
Reported LPN Staffing Hours per Resident per Day
0.49423
Reported RN Staffing Hours per Resident per Day
5.17692
Reported Licensed Staffing Hours per Resident per Day
5.67115
Reported Total Nurse Staffing Hours per Resident per Day
8.50577
Reported Physical Therapist Staffing Hours per Resident Per Day
0.50577
Expected CNA Staffing Hours per Resident per Day
2.54888
Expected LPN Staffing Hours per Resident per Day
1.07957
Expected RN Staffing Hours per Resident per Day
1.80058
Expected Total Nurse Staffing Hours per Resident per Day
5.42903
Adjusted CNA Staffing Hours per Resident per Day
2.72877
Adjusted LPN Staffing Hours per Resident per Day
0.37998
Adjusted RN Staffing Hours per Resident per Day
2.14831
Adjusted Total Nurse Staffing Hours per Resident per Day
6.31530
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-08-08
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-11-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
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
2012-12-05
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
1.33300
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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