2 health deficiencies
Top issue: Pharmacy Service (1 deficiency)
8 fire-safety deficiencies
Top issue: Emergency Preparedness (3 deficiencies)
Vienna, IL
3-star overall rating with 4-star inspections with $98,504 in total fines with 2 recent health deficiencies with 8 fire-safety deficiencies in the latest cycle
512 North 11th Street, Vienna, IL
(618) 658-2951
Overall
3 / 5
CMS overall stars
Health inspections
4 / 5
Survey and complaint cycles
Staffing
1 / 5
RN + nurse staffing
Quality measures
2 / 5
Resident outcomes and process measures
Quick facts
Beds
50
Certified beds
Average residents
43
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Wlc Management Firm
Operator or chain grouping
Approved since
1996-05-15
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
17 facilities
Chain averages 3 overall / 4 health / 1 staffing / 1 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
RN hours / resident day
0.58
Registered nurse staffing · state 0.73 · national 0.68
LPN hours / resident day
0.60
Licensed practical nurse staffing · state 0.64 · national 0.87
Aide hours / resident day
1.42
Nurse aide staffing · state 2.13 · national 2.35
Total nurse hours
2.60
All reported nurse hours · state 3.49 · national 3.89
Licensed hours
1.18
RN + LPN hours · state 1.36 · national 1.54
Weekend hours
2.24
Weekend nurse staffing · state 3.09 · national 3.43
Weekend RN hours
0.58
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
0.62
CMS adjusted RN staffing hours
Adjusted total hours
2.81
CMS adjusted total nurse staffing hours
Case-mix index
1.27
Higher values indicate more complex resident acuity
RN turnover
0%
Annual RN turnover
Total nurse turnover
0%
Annual nurse turnover
SNF VBP
Program rank
6,343
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
33.23
Composite VBP score used to determine payment impact.
Payment multiplier
0.9876
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
Readmission
Not reported
This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.
Healthcare-associated infections
Not reported
This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.
Total nurse turnover
5.97
Baseline 14.29% · Performance 39.29% · Measure score 5.97 · Achievement 5.97 · Improvement 0
Adjusted total nurse staffing
0.68
Baseline 2.98 hours · Performance 3.27 hours · Measure score 0.68 · Achievement 0.68 · Improvement 0.53
SNF QRP
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 13.26% |
10.72%
2.5 pts worse
|
No Different than the National Rate · Eligible stays 31 · Observed rate 29.03% · Lower 95% interval 8.12% |
| Discharge to community | Not Available |
50.57%
|
Not Available · Eligible stays 20 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly. |
| Medicare spending per beneficiary | 1.12 |
1.02
0.1 pts worse
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 34 · Denominator 34 |
| Falls with major injury | 2.94% |
0.77%
2.2 pts worse
|
Numerator 1 · Denominator 34 |
| Discharge self-care score | 52% |
53.69%
1.7 pts worse
|
Numerator 13 · Denominator 25 |
| Discharge mobility score | 44% |
50.94%
6.9 pts worse
|
Numerator 11 · Denominator 25 |
| Pressure ulcers or injuries, new or worsened | 0% |
2.29%
2.3 pts better
|
Numerator 0 · Denominator 34 · Adjusted rate 0% |
| Healthcare-associated infections requiring hospitalization | Not Available |
7.12%
|
Not Available · Eligible stays 20 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly. |
| Staff COVID-19 vaccination coverage | 0% |
8.2%
8.2 pts worse
|
Numerator 0 · Denominator 45 |
| Staff flu vaccination coverage | 63.08% |
42%
21.1 pts better
|
Numerator 41 · Denominator 65 |
| Discharge function score | 52% |
56.45%
4.5 pts worse
|
Numerator 13 · Denominator 25 |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 8 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 10 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | Not Available |
25.2%
|
Numerator Not Available · Denominator 19 · Too few residents or stays to report publicly. |
Quality measures
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 1.4 |
2.0
0.6 pts better
|
1.9
0.5 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.4 · Observed 1.3 · Expected 1.8 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 1.4 |
2.3
0.9 pts better
|
1.8
0.4 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.4 · Observed 1.5 · Expected 1.7 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 100.0% |
89.6%
10.4 pts better
|
93.4%
6.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 100.0% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% |
91.6%
8.4 pts better
|
95.5%
4.5 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 2.1% |
3.3%
1.2 pts better
|
3.3%
1.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 2.6% · Q3 2.6% · Q4 2.7% · 4Q avg 2.1% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 1.5% |
50.3%
48.8 pts better
|
11.4%
9.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 5.7% · Q3 0.0% · Q4 0.0% · 4Q avg 1.5% |
| Percentage of long-stay residents who lose too much weight | 5.8% |
6.5%
0.7 pts better
|
5.4%
0.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 2.9% · Q3 8.8% · Q4 10.7% · 4Q avg 5.8% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 32.5% |
18.5%
14 pts worse
|
19.6%
12.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 25.0% · Q2 30.6% · Q3 37.1% · Q4 35.5% · 4Q avg 32.5% |
| Percentage of long-stay residents who received an antipsychotic medication | 25.3% |
22.8%
2.5 pts worse
|
16.7%
8.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q2 29.6% · Q3 26.7% · Q4 16.7% · 4Q avg 25.3% · 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 | 26.4% |
17.2%
9.2 pts worse
|
16.3%
10.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · 4Q avg 26.4% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 15.4% |
15.0%
0.4 pts worse
|
14.9%
0.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 9.1% · Q2 20.6% · Q3 6.2% · Q4 24.1% · 4Q avg 15.4% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 2.6% |
1.1%
1.5 pts worse
|
1.0%
1.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 3.1% · Q3 5.9% · Q4 0.0% · 4Q avg 2.6% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 4.4% |
1.7%
2.7 pts worse
|
1.7%
2.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 4.0% · Q2 7.9% · Q3 2.6% · Q4 2.9% · 4Q avg 4.4% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 20.0% |
21.3%
1.3 pts better
|
19.8%
0.2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 22.6% · Q2 29.0% · Q3 20.7% · Q4 6.1% · 4Q avg 20.0% |
| Percentage of long-stay residents with pressure ulcers | 5.9% |
5.2%
0.7 pts worse
|
5.1%
0.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 4.4% · Q2 2.2% · Q3 8.9% · Q4 7.6% · 4Q avg 5.9% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 100.0% |
68.8%
31.2 pts better
|
81.7%
18.3 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 100.0% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 16.6% |
14.0%
2.6 pts worse
|
12.0%
4.6 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 16.6% · Observed 17.6% · Expected 11.9% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 3.4% |
2.3%
1.1 pts worse
|
1.6%
1.8 pts worse
|
Short Stay · 2024Q4-2025Q3 · 4Q avg 3.4% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 100.0% |
63.0%
37 pts better
|
79.7%
20.3 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 100.0% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 25.9% |
26.2%
0.3 pts better
|
23.9%
2 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 25.9% · Observed 26.5% · Expected 24.4% · Used in QM five-star |
Survey summary
Top issue: Pharmacy Service (1 deficiency)
8 fire-safety deficiencies
Top issue: Emergency Preparedness (3 deficiencies)
No concentrated health issue counts in this cycle.
9 fire-safety deficiencies
Top issue: Smoke (4 deficiencies)
Top issue: Quality of Life and Care (3 deficiencies)
4 fire-safety deficiencies
Top issue: Emergency Preparedness (3 deficiencies)
Fire safety
Fire Safety
Address subsistence needs for staff and patients.
Corrected 2025-09-19
Fire Safety
Create arrangements with other facilities to receive patients.
Corrected 2025-09-19
Fire Safety
Conduct testing and exercise requirements.
Corrected 2025-09-19
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2025-09-25
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2025-09-25
Fire Safety
Install corridor and hallway doors that block smoke.
Corrected 2025-09-19
Fire Safety
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Corrected 2025-09-19
Fire Safety
Install emergency lighting that can last at least 1 1/2 hours.
Corrected 2025-09-19
Fire Safety
Implement emergency and standby power systems.
Corrected 2024-08-20
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2024-08-20
Fire Safety
Properly select, install, inspect, or maintain portable fire extinguishes.
Corrected 2024-08-20
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2024-08-20
Fire Safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2024-08-20
Fire Safety
Have exits that are accessible at all times.
Corrected 2024-08-20
Fire Safety
Install corridor and hallway doors that block smoke.
Corrected 2024-08-20
Fire Safety
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Corrected 2024-08-20
Fire Safety
Ensure proper usage of power strips and extension cords.
Corrected 2024-08-20
Fire Safety
Establish roles under a Waiver declared by secretary.
Corrected 2023-09-06
Fire Safety
Conduct testing and exercise requirements.
Corrected 2023-09-14
Fire Safety
Implement emergency and standby power systems.
Corrected 2023-09-06
Fire Safety
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Corrected 2023-09-06
Inspection history
Health
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.
Corrected 2025-06-20
Health
Provide enough food/fluids to maintain a resident's health.
Corrected 2025-06-20
Health
Honor the resident's right to receive visitors of his or her choosing, at the time of his or her choosing.
Corrected 2023-08-22
Health
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Corrected 2023-08-22
Health
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Corrected 2023-08-22
Health
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Corrected 2023-08-22
Health
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2023-05-05
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2023-05-05
Health
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Corrected 2023-05-23
Penalties and ownership
Fine · fine $98,504
Fine
5% Or Greater Indirect Ownership Interest · Individual
5% Or Greater Direct Ownership Interest · Organization
Operational/Managerial Control · Individual
Corporate Officer · Individual
Operational/Managerial Control · Organization
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