Timbercreek Rehab & Healthcare Center - Pekin Nursing Home
General Information
UPDATEFederal Provider Number
145275
Provider Name
TIMBERCREEK REHAB & HEALTHCARE CENTER
Provider Address
2220 STATE STREET
PEKIN, IL 61554
PEKIN, IL 61554
Provider Phone Number
(309) 347-1110
Provider SSA County
980
Provider County Name
Tazewell
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
202
Number of Residents in Certified Beds
130
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PETERSEN HEALTH OPERATIONS, LLC
Date First Approved to Provide Medicare and Medicaid services
1974-02-01
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
4
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.00000
Reported LPN Staffing Hours per Resident per Day
0.58231
Reported RN Staffing Hours per Resident per Day
0.44962
Reported Licensed Staffing Hours per Resident per Day
1.03192
Reported Total Nurse Staffing Hours per Resident per Day
3.03193
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04385
Expected CNA Staffing Hours per Resident per Day
2.37446
Expected LPN Staffing Hours per Resident per Day
0.65394
Expected RN Staffing Hours per Resident per Day
0.99356
Expected Total Nurse Staffing Hours per Resident per Day
4.02197
Adjusted CNA Staffing Hours per Resident per Day
2.06674
Adjusted LPN Staffing Hours per Resident per Day
0.73908
Adjusted RN Staffing Hours per Resident per Day
0.33813
Adjusted Total Nurse Staffing Hours per Resident per Day
3.03867
Cycle 1 Total Number of Health Deficiencies
25
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
21
Cycle 1 Health Deficiency Score
265
Cycle 1 Standard Survey Health Date
2014-09-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
265
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
88
Cycle 2 Standard Health Survey Date
2013-07-24
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
44
Cycle 2 Total Health Score
132
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2012-08-31
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
32
Cycle 3 Total Health Score
96
Total Weighted Health Survey Score
192.50000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
13
Number of Fines
2
Total Amount of Fines in Dollars
25843
Number of Payment Denials
1
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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