Presence Our Lady Of Victory - Bourbonnais Nursing Home
General Information
UPDATEFederal Provider Number
145536
Provider Name
PRESENCE OUR LADY OF VICTORY
Provider Address
20 BRIARCLIFF LANE
BOURBONNAIS, IL 60914
BOURBONNAIS, IL 60914
Provider Phone Number
8159372022
Provider SSA County
540
Provider County Name
Kankakee
Ownership Type
Non profit - Church related
Number of Certified Beds
107
Number of Residents in Certified Beds
98
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PRESENCE LIFE CONNECTIONS
Date First Approved to Provide Medicare and Medicaid services
1986-01-29
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.08112
Reported LPN Staffing Hours per Resident per Day
0.76378
Reported RN Staffing Hours per Resident per Day
0.83724
Reported Licensed Staffing Hours per Resident per Day
1.60102
Reported Total Nurse Staffing Hours per Resident per Day
3.68214
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04541
Expected CNA Staffing Hours per Resident per Day
2.54939
Expected LPN Staffing Hours per Resident per Day
0.61239
Expected RN Staffing Hours per Resident per Day
1.07000
Expected Total Nurse Staffing Hours per Resident per Day
4.23179
Adjusted CNA Staffing Hours per Resident per Day
2.00300
Adjusted LPN Staffing Hours per Resident per Day
1.03518
Adjusted RN Staffing Hours per Resident per Day
0.58466
Adjusted Total Nurse Staffing Hours per Resident per Day
3.50734
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-07-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-08-16
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
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2012-09-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
43.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
2
Total Amount of Fines in Dollars
10920
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Kankakee Terrace Nursing Ctr
100 Belle Aire |
BOURBONNAIS IL 60914 | 1.2 miles away
Bourbonnais Terrace Nursing Home
133 Mohawk Drive |
BOURBONNAIS IL 60914 | 1.4 miles away
Presence Heritage Village
901 North Entrance Avenue |
KANKAKEE IL 60901 | 2 miles away
Miller Health Care Center
1601 Butterfield Trail |
KANKAKEE IL 60901 | 2 miles away
Manorcare Of Kankakee
900 West River Place |
KANKAKEE IL 60901 | 2.2 miles away
River North Of Bradley H & R
650 North Kinzie |
BRADLEY IL 60915 | 2.3 miles away
Momence Meadows Nursing & Rehab
500 South Walnut |
MOMENCE IL 60954 | 12.2 miles away
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