Illinois Nursing Homes >> Stockton Nursing Homes >> Waverly Place Of Stockton

Waverly Place Of Stockton - Stockton Nursing Home

General Information

UPDATE
Federal Provider Number
146147
Provider Name
WAVERLY PLACE OF STOCKTON
Provider Address
501 EAST FRONT STREET, PO BOX #38
STOCKTON, IL 61085
Provider Phone Number
8159472215
Provider SSA County
510
Provider County Name
Jo Daviess
Ownership Type
For profit - Corporation
Number of Certified Beds
49
Number of Residents in Certified Beds
34
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
2011-05-30
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
1
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
2.38971
Reported LPN Staffing Hours per Resident per Day
0.17500
Reported RN Staffing Hours per Resident per Day
0.86324
Reported Licensed Staffing Hours per Resident per Day
1.03824
Reported Total Nurse Staffing Hours per Resident per Day
3.42795
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.52691
Expected LPN Staffing Hours per Resident per Day
0.62847
Expected RN Staffing Hours per Resident per Day
0.85335
Expected Total Nurse Staffing Hours per Resident per Day
4.00873
Adjusted CNA Staffing Hours per Resident per Day
2.32048
Adjusted LPN Staffing Hours per Resident per Day
0.23112
Adjusted RN Staffing Hours per Resident per Day
0.75586
Adjusted Total Nurse Staffing Hours per Resident per Day
3.44691
Cycle 1 Total Number of Health Deficiencies
20
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
9
Cycle 1 Health Deficiency Score
373
Cycle 1 Standard Survey Health Date
2014-05-07
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
373
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
96
Cycle 2 Standard Health Survey Date
2013-07-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
76
Cycle 3 Standard Health Survey Date
2012-06-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
76
Total Weighted Health Survey Score
231.16700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
10
Number of Fines
1
Total Amount of Fines in Dollars
85735
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01

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