Wabash Christian Retirement - Carmi Nursing Home
General Information
UPDATEFederal Provider Number
146019
Provider Name
WABASH CHRISTIAN RETIREMENT
Provider Address
216 COLLEGE BOULEVARD
CARMI, IL 62821
CARMI, IL 62821
Provider Phone Number
(618) 382-4644
Provider SSA County
987
Provider County Name
White
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
156
Number of Residents in Certified Beds
138
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CHRISTIAN HOMES, INC
Date First Approved to Provide Medicare and Medicaid services
2001-12-21
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
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.25072
Reported LPN Staffing Hours per Resident per Day
0.60507
Reported RN Staffing Hours per Resident per Day
0.76123
Reported Licensed Staffing Hours per Resident per Day
1.36630
Reported Total Nurse Staffing Hours per Resident per Day
3.61702
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08732
Expected CNA Staffing Hours per Resident per Day
2.43206
Expected LPN Staffing Hours per Resident per Day
0.70060
Expected RN Staffing Hours per Resident per Day
1.12219
Expected Total Nurse Staffing Hours per Resident per Day
4.25486
Adjusted CNA Staffing Hours per Resident per Day
2.27075
Adjusted LPN Staffing Hours per Resident per Day
0.71682
Adjusted RN Staffing Hours per Resident per Day
0.50686
Adjusted Total Nurse Staffing Hours per Resident per Day
3.42664
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2015-04-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2014-03-27
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
103
Cycle 3 Standard Health Survey Date
2013-05-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
103
Total Weighted Health Survey Score
42.50000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
8
Number of Fines
1
Total Amount of Fines in Dollars
7118
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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