Kensington Place Nrsg & Rehab - Chicago Nursing Home
General Information
UPDATEFederal Provider Number
145829
Provider Name
KENSINGTON PLACE NRSG & REHAB
Provider Address
3405 SOUTH MICHIGAN AVENUE
CHICAGO, IL 60616
CHICAGO, IL 60616
Provider Phone Number
3127910035
Provider SSA County
141
Provider County Name
Cook
Ownership Type
For profit - Partnership
Number of Certified Beds
155
Number of Residents in Certified Beds
140
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
KENSINGTON PLACE NURSING AND REHABILITATION CENTER LLC
Date First Approved to Provide Medicare and Medicaid services
1995-04-04
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
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
1.35500
Reported LPN Staffing Hours per Resident per Day
0.89000
Reported RN Staffing Hours per Resident per Day
0.18821
Reported Licensed Staffing Hours per Resident per Day
1.07821
Reported Total Nurse Staffing Hours per Resident per Day
2.43321
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04071
Expected CNA Staffing Hours per Resident per Day
2.14827
Expected LPN Staffing Hours per Resident per Day
0.57010
Expected RN Staffing Hours per Resident per Day
0.84893
Expected Total Nurse Staffing Hours per Resident per Day
3.56729
Adjusted CNA Staffing Hours per Resident per Day
1.54765
Adjusted LPN Staffing Hours per Resident per Day
1.29574
Adjusted RN Staffing Hours per Resident per Day
0.16566
Adjusted Total Nurse Staffing Hours per Resident per Day
2.74943
Cycle 1 Total Number of Health Deficiencies
17
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
152
Cycle 1 Standard Survey Health Date
2015-04-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
152
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2014-05-30
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
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2013-03-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
98.00000
Number of Facility Reported Incidents
5
Number of Substantiated Complaints
3
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
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California Gardens N & Rehab C
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