Provider Name: CLINTON MANOR LIVING CENTER
Address: 111 EAST ILLINOIS STREET, NEW BADEN, IL 62265
Phone: (618) 588-4924
County: Clinton (130)
Ownership Type: For profit - Corporation
Certified Beds: 37
Average Residents Per Day: 20.7 ()
Provider Type: Medicare and Medicaid, Resides in Hospital: No
Legal Business Name: SOUTHERN ILLINOIS LIVING CENTERS INC.
First Approved Date: May 1, 2002
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: 4 ()
QM Rating: 2 ()
Long Stay QM Rating: 3 ()
Short Stay QM Rating: 2 ()
Staffing Rating: 5 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 4.34282, LPN Staff Hours Per Day: 1.8305, RN Staff Hours Per Day: 2.2845, Licensed Staff Hours Per Day: 4.1151
Total Nurse Staff Hours Per Day, per resident: 8.45797
Weekend Nurse Staff Hours: 6.99652, Weekend RN Staff Hours: 1.4931
PT Staff Hours Per Day, per resident: 0.0254
Nurse Staff Turnover: 32.1, Nurse Turnover Note:
RN Turnover: 9.1, RN Turnover Note:
Admin Left Number: 1, Admin Turnover Note:
Case Mix Nurse Aide Hours Per Day, per resident: 2.3137, Case Mix LPN Hours Per Day: 0.7319, Case Mix RN Hours Per Day: 0.3403
Adjusted Nurse Aide Hours Per Day, per resident: 3.82389, Adjusted LPN Hours Per Day: 1.8455, Adjusted RN Hours Per Day: 2.5295
Total Adjusted Nurse Hours Per Day, per resident: 7.87350
Adjusted Weekend Nurse Hours Per Day, per resident: 6.51305
Health Survey Dates and Scores: Cycle 1: 2023-08-11 (Score: 72), Cycle 2: 2022-06-23 (Score: 4), Cycle 3: 2021-03-18 (Score: 0)
Total Weighted Health Score: 37.333
Reported Incidents: 0, Substantiated Complaints: 2
Infection Control Citations:
Fines and Penalties: Number of Fines: 0, Total Fines in Dollars: 0.00, Payment Denials Number: 1, Total Penalties Number: 1
Location and GPS: 111 EAST ILLINOIS STREET,NEW BADEN,IL,62265 (38.5340, -89.699)
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: 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 2023-12-22
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 2023-09-08
Type: Health, Deficiency: Respond appropriately to all alleged violations.
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 2023-09-08
Type: Health, Deficiency: Provide enough food/fluids to maintain a resident's health.
Severity: G - Level 3: Actual harm that is not immediate jeopardy. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2023-09-08
Type: Health, Deficiency: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
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 2023-09-08
Type: Health, Deficiency: Provide and implement an infection prevention and control program.
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 2023-09-08
Type: Health, Deficiency: Implement a program that monitors antibiotic use.
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 2023-09-08
Type: Health, Deficiency: Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
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 2022-07-15
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: 0711, Version: New
Description: Provide a written emergency evacuation plan.
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 2022-08-19
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 2021-04-13
Type: Fire Safety, Tag: 0345, Version: New
Description: Have approved installation, maintenance and testing program for fire alarm systems.
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 2021-04-21
Type: Fire Safety, Tag: 0354, Version: New
Description: Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
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 2021-04-01
Type: Fire Safety, Tag: 0918, Version: New
Description: Have generator or other power source capable of supplying service within 10 seconds.
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 2021-04-06