Provider Name: FAIRFIELD MEMORIAL HOSPITAL
Address: NORTH WEST 11TH STREET, FAIRFIELD, IL 62837
Phone: (618) 842-2611
County: Wayne (986)
Ownership Type: Non profit - Other
Certified Beds: 30
Average Residents Per Day: 16.8 ()
Provider Type: Medicare, Resides in Hospital: No
Legal Business Name: FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION
First Approved Date: March 26, 1986
Affiliated Entity: ()
Retirement Community: N, Special Focus Status:
Ownership Change in Last 12 Months: N
Resident Family Council: Resident
Sprinkler System Status: Yes
Overall Rating: 5 ()
Health Inspection Rating: 5 ()
QM Rating: 5 ()
Long Stay QM Rating: 5 ()
Short Stay QM Rating: 5 ()
Staffing Rating: 5 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 2.73089, LPN Staff Hours Per Day: 0.0000, RN Staff Hours Per Day: 2.6756, Licensed Staff Hours Per Day: 2.6756
Total Nurse Staff Hours Per Day, per resident: 5.40657
Weekend Nurse Staff Hours: 4.35122, Weekend RN Staff Hours: 2.1764
PT Staff Hours Per Day, per resident: 0.0000
Nurse Staff Turnover: , Nurse Turnover Note: 6
RN Turnover: , RN Turnover Note: 6
Admin Left Number: , Admin Turnover Note: 6
Case Mix Nurse Aide Hours Per Day, per resident: 2.0783, Case Mix LPN Hours Per Day: 0.6743, Case Mix RN Hours Per Day: 0.3252
Adjusted Nurse Aide Hours Per Day, per resident: 2.67692, Adjusted LPN Hours Per Day: 0.0000, Adjusted RN Hours Per Day: 3.0994
Total Adjusted Nurse Hours Per Day, per resident: 5.53672
Adjusted Weekend Nurse Hours Per Day, per resident: 4.45596
Health Survey Dates and Scores: Cycle 1: 2023-09-08 (Score: 0), Cycle 2: 2022-10-20 (Score: 20), Cycle 3: 2021-09-30 (Score: 0)
Total Weighted Health Score: 6.667
Reported Incidents: 1, Substantiated Complaints: 0
Infection Control Citations:
Fines and Penalties: Number of Fines: 1, Total Fines in Dollars: 7442.50, Payment Denials Number: 0, Total Penalties Number: 1
Location and GPS: NORTH WEST 11TH STREET,FAIRFIELD,IL,62837 (38.3821, -88.362)
Process Date: 2024-03-01
Each record details specific health deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Health, Deficiency: Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Severity: G - Level 3: Actual harm that is not immediate jeopardy. Plan of Correction required.
Corrected: Past Non-Compliance on 2022-07-20
Each record details specific fire safety deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Fire Safety, Tag: 0222, Version: New
Description: Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-11-03