Advocate South Suburban Hospital-snf - Hazel Crest Nursing Home
General Information
UPDATEFederal Provider Number
145599
Provider Name
ADVOCATE SOUTH SUBURBAN HOSPITAL-SNF
Provider Address
17800 SOUTH KEDZIE AVENUE
HAZEL CREST, IL 60429
HAZEL CREST, IL 60429
Provider Phone Number
(708) 213-3166
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
41
Number of Residents in Certified Beds
31
Provider Type
Medicare
Provider Resides in Hospital
Y
Legal Business Name
ADVOCATE HEALTH AND HOSPITALS CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1988-10-12
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
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
2.32258
Reported LPN Staffing Hours per Resident per Day
0.00000
Reported RN Staffing Hours per Resident per Day
4.09194
Reported Licensed Staffing Hours per Resident per Day
4.09194
Reported Total Nurse Staffing Hours per Resident per Day
6.41452
Reported Physical Therapist Staffing Hours per Resident Per Day
0.39194
Expected CNA Staffing Hours per Resident per Day
2.35266
Expected LPN Staffing Hours per Resident per Day
0.87237
Expected RN Staffing Hours per Resident per Day
1.95246
Expected Total Nurse Staffing Hours per Resident per Day
5.17749
Adjusted CNA Staffing Hours per Resident per Day
2.42233
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
1.56597
Adjusted Total Nurse Staffing Hours per Resident per Day
4.99398
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
72
Cycle 1 Standard Survey Health Date
2015-01-29
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
72
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2014-04-02
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2013-02-15
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
40.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
0
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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