Bronzeville Park Nsg & Lvg Ctr - Chicago Nursing Home
General Information
UPDATEFederal Provider Number
145337
Provider Name
BRONZEVILLE PARK NSG & LVG CTR
Provider Address
3400 SOUTH INDIANA
CHICAGO, IL 60616
CHICAGO, IL 60616
Provider Phone Number
3128425000
Provider SSA County
141
Provider County Name
Cook
Ownership Type
For profit - Individual
Number of Certified Beds
302
Number of Residents in Certified Beds
273
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CHEVY CHASE CORP
Date First Approved to Provide Medicare and Medicaid services
1977-04-22
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.84121
Reported LPN Staffing Hours per Resident per Day
0.94707
Reported RN Staffing Hours per Resident per Day
0.30055
Reported Licensed Staffing Hours per Resident per Day
1.24762
Reported Total Nurse Staffing Hours per Resident per Day
3.08883
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11245
Expected CNA Staffing Hours per Resident per Day
2.40384
Expected LPN Staffing Hours per Resident per Day
0.67823
Expected RN Staffing Hours per Resident per Day
1.09430
Expected Total Nurse Staffing Hours per Resident per Day
4.17637
Adjusted CNA Staffing Hours per Resident per Day
1.87940
Adjusted LPN Staffing Hours per Resident per Day
1.15900
Adjusted RN Staffing Hours per Resident per Day
0.20522
Adjusted Total Nurse Staffing Hours per Resident per Day
2.98124
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
6
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2014-09-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
6
Cycle 2 Health Deficiency Score
80
Cycle 2 Standard Health Survey Date
2013-10-31
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
12
Cycle 3 Health Deficiency Score
226
Cycle 3 Standard Health Survey Date
2012-11-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
226
Total Weighted Health Survey Score
96.33300
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
41
Number of Fines
2
Total Amount of Fines in Dollars
7000
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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