Bethesda Home & Retirement Ctr - Chicago Nursing Home

General Information

UPDATE

Federal Provider Number

145844

Provider Name

BETHESDA HOME & RETIREMENT CTR

Provider Address

2833 NORTH NORDICA AVENUE
CHICAGO, IL 60634

Provider Phone Number

(773) 622-6144

Provider SSA County

141

Provider County Name

Cook

Provider Website

Provider Description

Ownership Type

Non profit - Corporation

Number of Certified Beds

Number of Residents in Certified Beds

Provider Type

Medicare and Medicaid

Provider Resides in Hospital

Legal Business Name

NORWEGIAN LUTHERAN BETHESDA HOME ASSOCIATION

Date First Approved to Provide Medicare and Medicaid services

1995-08-01

Continuing Care Retirement Community

Special Focus Facility

Provider Changed Ownership in Last 12 Months

With a Resident and Family Council

Resident

Automatic Sprinkler Systems in All Required Areas

Yes

Rating Detail Information

Overall Rating

Overall Rating Footnote

Health Inspection Rating

Health Inspection Rating Footnote

QM Rating

QM Rating Footnote

Staffing Rating

Staffing Rating Footnote

RN Staffing Rating

RN Staffing Rating Footnote

Reported Staffing Footnote

Physical Therapist Staffing Footnote

Reported CNA Staffing Hours per Resident per Day

3.03790

Reported LPN Staffing Hours per Resident per Day

0.55161

Reported RN Staffing Hours per Resident per Day

0.88226

Reported Licensed Staffing Hours per Resident per Day

1.43387

Reported Total Nurse Staffing Hours per Resident per Day

4.47177

Reported Physical Therapist Staffing Hours per Resident Per Day

0.00806

Expected CNA Staffing Hours per Resident per Day

2.44987

Expected LPN Staffing Hours per Resident per Day

0.55219

Expected RN Staffing Hours per Resident per Day

0.87657

Expected Total Nurse Staffing Hours per Resident per Day

3.87863

Adjusted CNA Staffing Hours per Resident per Day

3.04264

Adjusted LPN Staffing Hours per Resident per Day

0.82914

Adjusted RN Staffing Hours per Resident per Day

0.75205

Adjusted Total Nurse Staffing Hours per Resident per Day

4.64733

Cycle 1 Total Number of Health Deficiencies

Cycle 1 Number of Standard Health Deficiencies

Cycle 1 Number of Complaint Health Deficiencies

Cycle 1 Health Deficiency Score

Cycle 1 Standard Survey Health Date

2014-06-13

Cycle 1 Number of Health Revisits

Cycle 1 Health Revisit Score

Cycle 1 Total Health Score

Cycle 2 Total Number of Health Deficiencies

Cycle 2 Number of Standard Health Deficiencies

Cycle 2 Number of Complaint Health Deficiencies

Cycle 2 Health Deficiency Score

Cycle 2 Standard Health Survey Date

2013-07-25

Cycle 2 Number of Health Revisits

Cycle 2 Health Revisit Score

Cycle 2 Total Health Score

Cycle 3 Total Number of Health Deficiencies

Cycle 3 Number of Standard Health Deficiencies

Cycle 3 Number of Complaint Health Deficiencies

Cycle 3 Health Deficiency Score

Cycle 3 Standard Health Survey Date

2012-08-17

Cycle 3 Number of Health Revisits

Cycle 3 Health Revisit Score

Cycle 3 Total Health Score

Total Weighted Health Survey Score

28.00000

Number of Facility Reported Incidents

Number of Substantiated Complaints

Number of Fines

Total Amount of Fines in Dollars

Number of Payment Denials

Total Number of Penalties

Location

Processing Date

2015-06-01

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