Balmoral Home - Chicago Nursing Home

General Information

UPDATE
Federal Provider Number
145796
Provider Name
BALMORAL HOME
Provider Address
2055 WEST BALMORAL AVENUE
CHICAGO, IL 60625
Provider Phone Number
(773) 561-8661
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
213
Number of Residents in Certified Beds
201
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BALMORAL HOME INC
Date First Approved to Provide Medicare and Medicaid services
1994-07-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
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
1.62761
Reported LPN Staffing Hours per Resident per Day
0.14204
Reported RN Staffing Hours per Resident per Day
0.58980
Reported Licensed Staffing Hours per Resident per Day
0.73184
Reported Total Nurse Staffing Hours per Resident per Day
2.35945
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02836
Expected CNA Staffing Hours per Resident per Day
1.88735
Expected LPN Staffing Hours per Resident per Day
0.54428
Expected RN Staffing Hours per Resident per Day
0.78216
Expected Total Nurse Staffing Hours per Resident per Day
3.21379
Adjusted CNA Staffing Hours per Resident per Day
2.11602
Adjusted LPN Staffing Hours per Resident per Day
0.21660
Adjusted RN Staffing Hours per Resident per Day
0.56344
Adjusted Total Nurse Staffing Hours per Resident per Day
2.95934
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2015-01-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2014-03-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2013-03-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
21.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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