Bria Of Forest Edge - Chicago Nursing Home
General Information
UPDATEFederal Provider Number
145864
Provider Name
BRIA OF FOREST EDGE
Provider Address
8001 SOUTH WESTERN AVENUE
CHICAGO, IL 60620
CHICAGO, IL 60620
Provider Phone Number
(773) 436-6600
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
328
Number of Residents in Certified Beds
257
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FOREST EDGE HEALTHCARE & REHABILITATION CENTER 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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.90370
Reported LPN Staffing Hours per Resident per Day
0.61148
Reported RN Staffing Hours per Resident per Day
0.26673
Reported Licensed Staffing Hours per Resident per Day
0.87821
Reported Total Nurse Staffing Hours per Resident per Day
2.78191
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06673
Expected CNA Staffing Hours per Resident per Day
2.13321
Expected LPN Staffing Hours per Resident per Day
0.56009
Expected RN Staffing Hours per Resident per Day
0.82480
Expected Total Nurse Staffing Hours per Resident per Day
3.51811
Adjusted CNA Staffing Hours per Resident per Day
2.18971
Adjusted LPN Staffing Hours per Resident per Day
0.90616
Adjusted RN Staffing Hours per Resident per Day
0.24163
Adjusted Total Nurse Staffing Hours per Resident per Day
3.18740
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2014-07-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
80
Cycle 2 Total Number of Health Deficiencies
19
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
7
Cycle 2 Health Deficiency Score
116
Cycle 2 Standard Health Survey Date
2013-09-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
116
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2012-09-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
82.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
20
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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