Applewood Rehabilitation Center - Matteson Nursing Home
General Information
UPDATEFederal Provider Number
145781
Provider Name
APPLEWOOD REHABILITATION CENTER
Provider Address
21020 KOSTNER AVENUE
MATTESON, IL 60443
MATTESON, IL 60443
Provider Phone Number
7087471300
Provider SSA County
141
Provider County Name
Cook
Ownership Type
For profit - Partnership
Number of Certified Beds
115
Number of Residents in Certified Beds
105
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
APPLEWOOD REHABILITATION CENTER LLC
Date First Approved to Provide Medicare and Medicaid services
1993-12-22
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
3
QM Rating Footnote
Staffing Rating
2
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
1.96000
Reported LPN Staffing Hours per Resident per Day
0.45905
Reported RN Staffing Hours per Resident per Day
0.61619
Reported Licensed Staffing Hours per Resident per Day
1.07524
Reported Total Nurse Staffing Hours per Resident per Day
3.03524
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09571
Expected CNA Staffing Hours per Resident per Day
2.57822
Expected LPN Staffing Hours per Resident per Day
0.62643
Expected RN Staffing Hours per Resident per Day
0.97025
Expected Total Nurse Staffing Hours per Resident per Day
4.17490
Adjusted CNA Staffing Hours per Resident per Day
1.86534
Adjusted LPN Staffing Hours per Resident per Day
0.60823
Adjusted RN Staffing Hours per Resident per Day
0.47453
Adjusted Total Nurse Staffing Hours per Resident per Day
2.93055
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-07-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-06-21
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
29
Cycle 3 Number of Standard Health Deficiencies
27
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
168
Cycle 3 Standard Health Survey Date
2012-05-18
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
84
Cycle 3 Total Health Score
252
Total Weighted Health Survey Score
74.66700
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
9
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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