Meadowbrook Manor - Bolingbrook - Bolingbrook Nursing Home
General Information
UPDATEFederal Provider Number
145710
Provider Name
MEADOWBROOK MANOR - BOLINGBROOK
Provider Address
431 WEST REMINGTON BOULEVARD
BOLINGBROOK, IL 60440
BOLINGBROOK, IL 60440
Provider Phone Number
6307591112
Provider SSA County
989
Provider County Name
Will
Ownership Type
For profit - Partnership
Number of Certified Beds
298
Number of Residents in Certified Beds
278
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BUTTERFIELD HEALTH CARE, INC.
Date First Approved to Provide Medicare and Medicaid services
1991-12-05
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
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.53849
Reported LPN Staffing Hours per Resident per Day
0.77086
Reported RN Staffing Hours per Resident per Day
0.71169
Reported Licensed Staffing Hours per Resident per Day
1.48255
Reported Total Nurse Staffing Hours per Resident per Day
4.02104
Reported Physical Therapist Staffing Hours per Resident Per Day
0.17104
Expected CNA Staffing Hours per Resident per Day
2.66085
Expected LPN Staffing Hours per Resident per Day
0.65444
Expected RN Staffing Hours per Resident per Day
1.06554
Expected Total Nurse Staffing Hours per Resident per Day
4.38083
Adjusted CNA Staffing Hours per Resident per Day
2.34087
Adjusted LPN Staffing Hours per Resident per Day
0.97765
Adjusted RN Staffing Hours per Resident per Day
0.49907
Adjusted Total Nurse Staffing Hours per Resident per Day
3.69985
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-05-01
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-11-15
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
12
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
80
Cycle 3 Standard Health Survey Date
2013-05-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
80
Total Weighted Health Survey Score
47.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
6
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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