Bethesda Home & Retirement Ctr - Chicago Nursing Home
General Information
UPDATEFederal Provider Number
145844
Provider Name
BETHESDA HOME & RETIREMENT CTR
Provider Address
2833 NORTH NORDICA AVENUE
CHICAGO, IL 60634
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
88
Number of Residents in Certified Beds
62
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
NORWEGIAN LUTHERAN BETHESDA HOME ASSOCIATION
Date First Approved to Provide Medicare and Medicaid services
1995-08-01
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
4
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
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
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-06-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-07-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-08-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
28.00000
Number of Facility Reported Incidents
1
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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