Avantara Long Grove - Long Grove Nursing Home
General Information
UPDATEFederal Provider Number
145868
Provider Name
AVANTARA LONG GROVE
Provider Address
1666 CHECKER ROAD
LONG GROVE, IL 60047
LONG GROVE, IL 60047
Provider Phone Number
(847) 419-1111
Provider SSA County
570
Provider County Name
Lake
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
190
Number of Residents in Certified Beds
160
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LONG GROVE PAC LLC
Date First Approved to Provide Medicare and Medicaid services
1996-03-01
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
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
1.87500
Reported LPN Staffing Hours per Resident per Day
0.83469
Reported RN Staffing Hours per Resident per Day
1.04438
Reported Licensed Staffing Hours per Resident per Day
1.87906
Reported Total Nurse Staffing Hours per Resident per Day
3.75407
Reported Physical Therapist Staffing Hours per Resident Per Day
0.17875
Expected CNA Staffing Hours per Resident per Day
2.51362
Expected LPN Staffing Hours per Resident per Day
0.67304
Expected RN Staffing Hours per Resident per Day
1.22265
Expected Total Nurse Staffing Hours per Resident per Day
4.40930
Adjusted CNA Staffing Hours per Resident per Day
1.83031
Adjusted LPN Staffing Hours per Resident per Day
1.02935
Adjusted RN Staffing Hours per Resident per Day
0.63825
Adjusted Total Nurse Staffing Hours per Resident per Day
3.43190
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-10-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-09-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
92
Cycle 3 Standard Health Survey Date
2012-09-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
92
Total Weighted Health Survey Score
55.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
6
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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