Valley Hi Nursing Home - Woodstock Nursing Home
General Information
UPDATEFederal Provider Number
145652
Provider Name
VALLEY HI NURSING HOME
Provider Address
2406 HARTLAND ROAD
WOODSTOCK, IL 60098
WOODSTOCK, IL 60098
Provider Phone Number
(815) 338-0312
Provider SSA County
640
Provider County Name
Mc Henry
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
128
Number of Residents in Certified Beds
126
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTY OF MCHENRY ILLINOIS
Date First Approved to Provide Medicare and Medicaid services
1989-10-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
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
2.27778
Reported LPN Staffing Hours per Resident per Day
0.26627
Reported RN Staffing Hours per Resident per Day
0.98294
Reported Licensed Staffing Hours per Resident per Day
1.24921
Reported Total Nurse Staffing Hours per Resident per Day
3.52699
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04484
Expected CNA Staffing Hours per Resident per Day
2.48866
Expected LPN Staffing Hours per Resident per Day
0.57162
Expected RN Staffing Hours per Resident per Day
0.83613
Expected Total Nurse Staffing Hours per Resident per Day
3.89642
Adjusted CNA Staffing Hours per Resident per Day
2.24578
Adjusted LPN Staffing Hours per Resident per Day
0.38663
Adjusted RN Staffing Hours per Resident per Day
0.87839
Adjusted Total Nurse Staffing Hours per Resident per Day
3.64872
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2015-01-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
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
24
Cycle 2 Standard Health Survey Date
2014-03-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2013-04-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
30.00000
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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