Provider Name: APOSTOLIC CHRISTIAN HOME
Address: 1102 WEST RANDOLPH, ROANOKE, IL 61561
Phone: (309) 923-2071
County: Woodford (992)
Ownership Type: Non profit - Church related
Certified Beds: 60
Average Residents Per Day: 46.5 ()
Provider Type: Medicare and Medicaid, Resides in Hospital: No
Legal Business Name: APOSTOLIC CHRISTIAN HOME OF ROANOKE ILLINOIS INC.
First Approved Date: October 15, 1991
Affiliated Entity: ()
Retirement Community: N, Special Focus Status:
Ownership Change in Last 12 Months: N
Resident Family Council: None
Sprinkler System Status: Yes
Overall Rating: 5 ()
Health Inspection Rating: 5 ()
QM Rating: 4 ()
Long Stay QM Rating: 4 ()
Short Stay QM Rating: 4 ()
Staffing Rating: 5 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 2.67804, LPN Staff Hours Per Day: 0.4461, RN Staff Hours Per Day: 0.7867, Licensed Staff Hours Per Day: 1.2328
Total Nurse Staff Hours Per Day, per resident: 3.91088
Weekend Nurse Staff Hours: 3.28149, Weekend RN Staff Hours: 0.4754
PT Staff Hours Per Day, per resident: 0.0151
Nurse Staff Turnover: 37.3, Nurse Turnover Note:
RN Turnover: 0.0, RN Turnover Note:
Admin Left Number: , Admin Turnover Note: 6
Case Mix Nurse Aide Hours Per Day, per resident: 2.0088, Case Mix LPN Hours Per Day: 0.6180, Case Mix RN Hours Per Day: 0.2688
Adjusted Nurse Aide Hours Per Day, per resident: 2.71586, Adjusted LPN Hours Per Day: 0.5326, Adjusted RN Hours Per Day: 1.1028
Total Adjusted Nurse Hours Per Day, per resident: 4.25703
Adjusted Weekend Nurse Hours Per Day, per resident: 3.57193
Health Survey Dates and Scores: Cycle 1: 2023-03-09 (Score: 8), Cycle 2: 2022-06-23 (Score: 12), Cycle 3: 2021-09-16 (Score: 4)
Total Weighted Health Score: 8.667
Reported Incidents: 1, Substantiated Complaints: 0
Infection Control Citations: 0
Fines and Penalties: Number of Fines: 1, Total Fines in Dollars: 650.00, Payment Denials Number: 0, Total Penalties Number: 1
Location and GPS: 1102 WEST RANDOLPH,ROANOKE,IL,61561 (40.7948, -89.210)
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: Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2023-06-05
Type: Health, Deficiency: Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2023-06-05
Type: Health, Deficiency: Not require residents to give up Medicare or Medicaid benefits, or pay privately as a condition of admission; and must tell residents what care they do not provide.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-07-26
Type: Health, Deficiency: Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-07-26
Type: Health, Deficiency: Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-07-26
Type: Health, Deficiency: Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2021-10-01
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: 0007, Version: New
Description: Address patient/client population and determine types of services needed.
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 2022-07-21
Type: Fire Safety, Tag: 0034, Version: New
Description: Provide a means of sharing information on occupancy/needs.
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 2022-07-21
Type: Fire Safety, Tag: 0321, Version: New
Description: Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Severity: E - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2022-07-21
Type: Fire Safety, Tag: 0293, Version: New
Description: Have properly located and lighted "Exit" signs.
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 2021-10-25