Cycle 1
Health 2025-02-27 · Fire 2025-02-27
6 health deficiencies
Top issue: Administration (1 deficiency)
5 fire-safety deficiencies
Top issue: Smoke (2 deficiencies)
Salem, IL
Doctors Nursing & Rehab Center
1-star overall rating with 3-star inspections with $67,088 in total fines with 6 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
1201 Hawthorn Road, Salem, IL
(618) 548-4884
Overall
1 / 5
CMS overall stars
Health inspections
3 / 5
Survey and complaint cycles
Staffing
1 / 5
RN + nurse staffing
Quality measures
1 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
120
Certified beds
Average residents
60
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Helia Healthcare
Operator or chain grouping
Approved since
1972-11-22
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
13 facilities
Chain averages 3 overall / 3 health / 1 staffing / 3 quality stars
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
0.40
Registered nurse staffing · state 0.73 · national 0.68
LPN hours / resident day
0.65
Licensed practical nurse staffing · state 0.64 · national 0.87
Aide hours / resident day
2.02
Nurse aide staffing · state 2.13 · national 2.35
Total nurse hours
3.07
All reported nurse hours · state 3.49 · national 3.89
Licensed hours
1.06
RN + LPN hours · state 1.36 · national 1.54
Weekend hours
2.86
Weekend nurse staffing · state 3.09 · national 3.43
Weekend RN hours
0.39
Weekend registered nurse coverage · state 0.56 · national 0.47
Physical therapist
0.01
Reported PT staffing · state 0.05 · national 0.07
Adjusted RN hours
0.30
CMS adjusted RN staffing hours
Adjusted total hours
2.29
CMS adjusted total nurse staffing hours
Case-mix index
1.84
Higher values indicate more complex resident acuity
RN turnover
54%
Annual RN turnover · state 44% · national 45%
Total nurse turnover
46%
Annual nurse turnover · state 46% · national 46%
SNF VBP
Value-based purchasing
Program rank
8,657
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
26.09
Composite VBP score used to determine payment impact.
Payment multiplier
0.9840
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
0
Baseline 18.46% · Performance 21.34% · Measure score 0 · Achievement 0 · Improvement 0
Healthcare-associated infections
5.52
Baseline 7.62% · Performance 6.19% · Measure score 5.52 · Achievement 5.52 · Improvement 4.96
Total nurse turnover
4.38
Baseline 63.16% · Performance 45.76% · Measure score 4.38 · Achievement 4.38 · Improvement 4.04
Adjusted total nurse staffing
0.54
Baseline 2.05 hours · Performance 2.44 hours · Measure score 0.54 · Achievement 0 · Improvement 0.54
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 11.43% |
10.72%
0.7 pts worse
|
No Different than the National Rate · Eligible stays 79 · Observed rate 13.92% · Lower 95% interval 8.21% |
| Discharge to community | 41.48% |
50.57%
9.1 pts worse
|
No Different than the National Rate · Eligible stays 78 · Observed rate 32.05% · Lower 95% interval 32.6% |
| Medicare spending per beneficiary | 1.35 |
1.02
0.3 pts worse
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 72 · Denominator 72 |
| Falls with major injury | 2.78% |
0.77%
2 pts worse
|
Numerator 2 · Denominator 72 |
| Discharge self-care score | 23.4% |
53.69%
30.3 pts worse
|
Numerator 11 · Denominator 47 |
| Discharge mobility score | 14.89% |
50.94%
36 pts worse
|
Numerator 7 · Denominator 47 |
| Pressure ulcers or injuries, new or worsened | 9.72% |
2.29%
7.4 pts worse
|
Numerator 7 · Denominator 72 · Adjusted rate 8.54% |
| Healthcare-associated infections requiring hospitalization | 6.19% |
7.12%
0.9 pts better
|
No Different than the National Rate · Eligible stays 55 · Observed rate 5.45% · Lower 95% interval 3.46% |
| Staff COVID-19 vaccination coverage | 1.22% |
8.2%
7 pts worse
|
Numerator 1 · Denominator 82 |
| Staff flu vaccination coverage | 12.94% |
42%
29.1 pts worse
|
Numerator 11 · Denominator 85 |
| Discharge function score | 21.28% |
56.45%
35.2 pts worse
|
Numerator 10 · Denominator 47 |
| Transfer of health information to provider | 100% |
95.95%
4 pts better
|
Numerator 24 · Denominator 24 |
| Transfer of health information to patient | 100% |
96.28%
3.7 pts better
|
Numerator 22 · Denominator 22 |
| Resident COVID-19 vaccinations up to date | 32.43% |
25.2%
7.2 pts better
|
Numerator 12 · Denominator 37 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 1.2 |
2.0
0.8 pts better
|
1.9
0.7 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.2 · Observed 1.8 · Expected 3.0 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 4.2 |
2.3
1.9 pts worse
|
1.8
2.4 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 4.2 · Observed 5.2 · Expected 2.0 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 90.8% |
89.6%
1.2 pts better
|
93.4%
2.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 93.2% · Q2 91.2% · Q3 90.9% · Q4 87.5% · 4Q avg 90.8% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 97.1% |
91.6%
5.5 pts better
|
95.5%
1.6 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 97.1% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 7.1% |
3.3%
3.8 pts worse
|
3.3%
3.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 8.5% · Q2 7.4% · Q3 7.3% · Q4 5.4% · 4Q avg 7.1% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 32.8% |
50.3%
17.5 pts better
|
11.4%
21.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 2.1% · Q2 8.6% · Q3 63.0% · Q4 65.2% · 4Q avg 32.8% |
| Percentage of long-stay residents who lose too much weight | 21.0% |
6.5%
14.5 pts worse
|
5.4%
15.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 16.4% · Q2 19.0% · Q3 23.1% · Q4 25.9% · 4Q avg 21.0% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 38.6% |
18.5%
20.1 pts worse
|
19.6%
19 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 42.9% · Q2 40.9% · Q3 36.4% · Q4 33.9% · 4Q avg 38.6% |
| Percentage of long-stay residents who received an antipsychotic medication | 19.4% |
22.8%
3.4 pts better
|
16.7%
2.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 17.1% · Q2 17.4% · Q3 21.4% · Q4 22.0% · 4Q avg 19.4% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.1%
0.1 pts better
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 25.2% |
17.2%
8 pts worse
|
16.3%
8.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · 4Q avg 25.2% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 15.8% |
15.0%
0.8 pts worse
|
14.9%
0.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 21.3% · Q2 13.8% · Q3 12.5% · Q4 16.3% · 4Q avg 15.8% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.5% |
1.1%
0.6 pts better
|
1.0%
0.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 1.1% · Q4 1.0% · 4Q avg 0.5% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 0.4% |
1.7%
1.3 pts better
|
1.7%
1.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 1.5% · Q3 0.0% · Q4 0.0% · 4Q avg 0.4% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 19.9% |
21.3%
1.4 pts better
|
19.8%
0.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 30.7% · Q2 14.5% · Q3 13.2% · Q4 20.7% · 4Q avg 19.9% |
| Percentage of long-stay residents with pressure ulcers | 11.1% |
5.2%
5.9 pts worse
|
5.1%
6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 10.4% · Q2 13.8% · Q3 10.1% · Q4 9.4% · 4Q avg 11.1% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 62.4% |
68.8%
6.4 pts worse
|
81.7%
19.3 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 62.5% · Q2 64.7% · Q3 66.0% · Q4 55.0% · 4Q avg 62.4% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 31.1% |
14.0%
17.1 pts worse
|
12.0%
19.1 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 31.1% · Observed 31.6% · Expected 11.3% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 3.8% |
2.3%
1.5 pts worse
|
1.6%
2.2 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 4.8% · Q2 3.6% · Q3 3.4% · Q4 3.8% · 4Q avg 3.8% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 66.0% |
63.0%
3 pts better
|
79.7%
13.7 pts worse
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 66.0% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 22.6% |
26.2%
3.6 pts better
|
23.9%
1.3 pts better
|
Short Stay · 20240701-20250630 · Adjusted 22.6% · Observed 23.7% · Expected 25.0% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-01-25 · Fire 2024-01-25
4 health deficiencies
Top issue: Nutrition and Dietary (2 deficiencies)
11 fire-safety deficiencies
Top issue: Emergency Preparedness (4 deficiencies)
Cycle 3
Health 2022-12-16 · Fire 2022-12-16
11 health deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (5 deficiencies)
11 fire-safety deficiencies
Top issue: Emergency Preparedness (4 deficiencies)
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2025-02-27
E41 · Emergency Preparedness Deficiencies
Fire Safety
Implement emergency and standby power systems.
Corrected 2025-03-20
F · Potential for more than minimal harm
2025-02-27
K281 · Egress Deficiencies
Fire Safety
Install proper backup exit lighting.
Corrected 2025-03-20
F · Potential for more than minimal harm
2025-02-27
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2025-05-20
E · Potential for more than minimal harm
2025-02-27
K374 · Smoke Deficiencies
Fire Safety
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Corrected 2025-03-20
E · Potential for more than minimal harm
2025-02-27
K920 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure proper usage of power strips and extension cords.
Corrected 2025-03-20
F · Potential for more than minimal harm
2024-01-25
E26 · Emergency Preparedness Deficiencies
Fire Safety
Establish roles under a Waiver declared by secretary.
Corrected 2024-02-26
F · Potential for more than minimal harm
2024-01-25
E37 · Emergency Preparedness Deficiencies
Fire Safety
Establish staff and initial training requirements.
Corrected 2024-02-26
F · Potential for more than minimal harm
2024-01-25
E39 · Emergency Preparedness Deficiencies
Fire Safety
Conduct testing and exercise requirements.
Corrected 2024-02-26
F · Potential for more than minimal harm
2024-01-25
E4 · Emergency Preparedness Deficiencies
Fire Safety
Develop and maintain an Emergency Preparedness Program (EP).
Corrected 2024-02-26
F · Potential for more than minimal harm
2024-01-25
K346 · Smoke Deficiencies
Fire Safety
Follow proper procedures when the fire alarm was out of service for more than 4 hours.
Corrected 2024-02-26
F · Potential for more than minimal harm
2024-01-25
K712 · Miscellaneous Deficiencies
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2024-02-26
F · Potential for more than minimal harm
2024-01-25
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2024-03-20
E · Potential for more than minimal harm
2024-01-25
K211 · Egress Deficiencies
Fire Safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2024-02-26
E · Potential for more than minimal harm
2024-01-25
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2024-02-26
E · Potential for more than minimal harm
2024-01-25
K354 · Smoke Deficiencies
Fire Safety
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
Corrected 2024-02-26
E · Potential for more than minimal harm
2024-01-25
K920 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure proper usage of power strips and extension cords.
Corrected 2024-02-26
F · Potential for more than minimal harm
2022-12-16
E36 · Emergency Preparedness Deficiencies
Fire Safety
Establish emergency prep training and testing.
Corrected 2023-01-18
F · Potential for more than minimal harm
2022-12-16
E37 · Emergency Preparedness Deficiencies
Fire Safety
Establish staff and initial training requirements.
Corrected 2023-01-18
F · Potential for more than minimal harm
2022-12-16
E39 · Emergency Preparedness Deficiencies
Fire Safety
Conduct testing and exercise requirements.
Corrected 2023-01-18
F · Potential for more than minimal harm
2022-12-16
E6 · Emergency Preparedness Deficiencies
Fire Safety
Conduct risk assessment and an All-Hazards approach.
Corrected 2023-01-18
F · Potential for more than minimal harm
2022-12-16
K291 · Egress Deficiencies
Fire Safety
Install emergency lighting that can last at least 1 1/2 hours.
Corrected 2023-01-19
F · Potential for more than minimal harm
2022-12-16
K293 · Egress Deficiencies
Fire Safety
Have properly located and lighted "Exit" signs.
Corrected 2023-01-19
F · Potential for more than minimal harm
2022-12-16
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2023-01-19
F · Potential for more than minimal harm
2022-12-16
K712 · Miscellaneous Deficiencies
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2023-01-19
F · Potential for more than minimal harm
2022-12-16
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2023-01-19
E · Potential for more than minimal harm
2022-12-16
K324 · Smoke Deficiencies
Fire Safety
Provide properly protected cooking facilities.
Corrected 2023-01-19
E · Potential for more than minimal harm
2022-12-16
K363 · Smoke Deficiencies
Fire Safety
Install corridor and hallway doors that block smoke.
Corrected 2023-01-19
Inspection history
Recent health citations
D · Potential for more than minimal harm
2025-12-12
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Respond appropriately to all alleged violations.
Corrected 2025-12-19
H · Actual harm
2025-08-12
F584 · Resident Rights Deficiencies
Health
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Corrected 2025-08-25
F · Potential for more than minimal harm
2025-08-12
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2025-08-21
F · Potential for more than minimal harm
2025-08-12
F835 · Administration Deficiencies
Health
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Corrected 2025-08-21
D · Potential for more than minimal harm
2025-08-12
F919 · Environmental Deficiencies
Health
Make sure that a working call system is available in each resident's bathroom and bathing area.
Corrected 2025-08-21
E · Potential for more than minimal harm
2025-02-27
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2025-03-07
F · Potential for more than minimal harm
2024-12-12
F584 · Resident Rights Deficiencies
Health
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Corrected 2025-01-11
E · Potential for more than minimal harm
2024-10-08
F803 · Nutrition and Dietary Deficiencies
Health
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Corrected 2024-10-25
E · Potential for more than minimal harm
2024-06-28
F807 · Nutrition and Dietary Deficiencies
Health
Ensure each resident receives and the facility provides drinks consistent with resident needs and preferences and sufficient to maintain resident hydration.
Corrected 2024-07-22
B · Minimal harm
2024-06-28
F584 · Resident Rights Deficiencies
Health
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Corrected 2024-07-22
G · Actual harm
2024-02-26
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2024-02-01
D · Potential for more than minimal harm
2024-02-26
F755 · Pharmacy Service Deficiencies
Health
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2024-03-05
D · Potential for more than minimal harm
2023-12-13
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2024-01-03
G · Actual harm
2023-08-25
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2023-09-08
D · Potential for more than minimal harm
2023-08-25
F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected 2023-09-08
D · Potential for more than minimal harm
2023-08-25
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Respond appropriately to all alleged violations.
Corrected 2023-09-08
G · Actual harm
2023-07-17
F686 · Quality of Life and Care Deficiencies
Health
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected 2023-07-25
D · Potential for more than minimal harm
2022-12-16
F604 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Corrected 2022-12-26
D · Potential for more than minimal harm
2022-12-16
F623 · Resident Rights Deficiencies
Health
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Corrected 2022-12-26
D · Potential for more than minimal harm
2022-12-16
F625 · Resident Rights Deficiencies
Health
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Corrected 2022-12-26
D · Potential for more than minimal harm
2022-12-16
F686 · Quality of Life and Care Deficiencies
Health
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected 2022-12-26
Penalties and ownership
What sits behind the stars
$12,284
2024-02-14
Fine
Fine · fine $12,284
Fine
$54,804
2023-08-25
Fine
Fine · fine $54,804
Fine
Ownership
Miller, Stephen
5% Or Greater Direct Ownership Interest · Individual
Miller, Stephen
Corporate Officer · Individual
Mills, Michael
Contracted Managing Employee · Individual
Nearby options
Other facilities in reach
#1
Twin Willows Nursing Center
Salem, IL
3-star overall rating with 4-star inspections with 12 recent health deficiencies with 8 fire-safety deficiencies in the latest cycle
#2
Odin Health And Rehab Center
Odin, IL
1-star overall rating with 1-star inspections with abuse icon flag with $176,517 in total fines with 22 recent health deficiencies with 22 fire-safety deficiencies in the latest cycle
#3
Centralia Manor
Centralia, IL
2-star overall rating with 2-star inspections with $98,011 in total fines with 15 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
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