Ambassador Nursing & Rehab Center - Chicago Nursing Home
General Information
UPDATEFederal Provider Number
145343
Provider Name
AMBASSADOR NURSING & REHAB CENTER
Provider Address
4900 NORTH BERNARD
CHICAGO, IL 60625
CHICAGO, IL 60625
Provider Phone Number
(773) 583-7130
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
190
Number of Residents in Certified Beds
148
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
AMBASSADOR NURSING AND REHABILITATION CENTER II LLC
Date First Approved to Provide Medicare and Medicaid services
1977-05-16
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
5
QM Rating Footnote
Staffing Rating
2
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
1.82061
Reported LPN Staffing Hours per Resident per Day
0.33209
Reported RN Staffing Hours per Resident per Day
1.01926
Reported Licensed Staffing Hours per Resident per Day
1.35135
Reported Total Nurse Staffing Hours per Resident per Day
3.17196
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04257
Expected CNA Staffing Hours per Resident per Day
2.34927
Expected LPN Staffing Hours per Resident per Day
0.66494
Expected RN Staffing Hours per Resident per Day
1.07758
Expected Total Nurse Staffing Hours per Resident per Day
4.09180
Adjusted CNA Staffing Hours per Resident per Day
1.90154
Adjusted LPN Staffing Hours per Resident per Day
0.41452
Adjusted RN Staffing Hours per Resident per Day
0.70676
Adjusted Total Nurse Staffing Hours per Resident per Day
3.12475
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-07-03
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-05-09
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-06-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
35.33300
Number of Facility Reported Incidents
0
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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