Illinois Nursing Homes >> Chicago Nursing Homes >> Smith Village

Smith Village - Chicago Nursing Home

General Information

UPDATE
Federal Provider Number
145904
Provider Name
SMITH VILLAGE
Provider Address
2320 WEST 113TH PLACE
CHICAGO, IL 60643
Provider Phone Number
7734747300
Provider SSA County
141
Provider County Name
Cook
Ownership Type
Non profit - Other
Number of Certified Beds
100
Number of Residents in Certified Beds
93
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WASHINGTON AND JANE SMITH COMMUNITY BEVERLY
Date First Approved to Provide Medicare and Medicaid services
1996-09-16
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.87634
Reported LPN Staffing Hours per Resident per Day
0.52473
Reported RN Staffing Hours per Resident per Day
1.10161
Reported Licensed Staffing Hours per Resident per Day
1.62634
Reported Total Nurse Staffing Hours per Resident per Day
4.50268
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05860
Expected CNA Staffing Hours per Resident per Day
2.58083
Expected LPN Staffing Hours per Resident per Day
0.56418
Expected RN Staffing Hours per Resident per Day
0.86646
Expected Total Nurse Staffing Hours per Resident per Day
4.01147
Adjusted CNA Staffing Hours per Resident per Day
2.73465
Adjusted LPN Staffing Hours per Resident per Day
0.77196
Adjusted RN Staffing Hours per Resident per Day
0.94998
Adjusted Total Nurse Staffing Hours per Resident per Day
4.52449
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-10-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-11-14
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
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-09-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
35.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
8
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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