Brookdale Plaza Lisle - Lisle Nursing Home
General Information
UPDATEFederal Provider Number
146061
Provider Name
BROOKDALE PLAZA LISLE
Provider Address
1800 ROBIN LANE
LISLE, IL 60532
LISLE, IL 60532
Provider Phone Number
(630) 353-5519
Provider SSA County
250
Provider County Name
Du Page
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
55
Number of Residents in Certified Beds
48
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
BROOKDALE LIVING COMMUNITIES OF ILLINOIS - DNC, LLC
Date First Approved to Provide Medicare and Medicaid services
2004-02-23
Continuing Care Retirement Community
Y
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
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
3.21563
Reported LPN Staffing Hours per Resident per Day
1.08646
Reported RN Staffing Hours per Resident per Day
0.98333
Reported Licensed Staffing Hours per Resident per Day
2.06979
Reported Total Nurse Staffing Hours per Resident per Day
5.28542
Reported Physical Therapist Staffing Hours per Resident Per Day
0.21771
Expected CNA Staffing Hours per Resident per Day
2.42411
Expected LPN Staffing Hours per Resident per Day
0.64880
Expected RN Staffing Hours per Resident per Day
1.19150
Expected Total Nurse Staffing Hours per Resident per Day
4.26441
Adjusted CNA Staffing Hours per Resident per Day
3.25488
Adjusted LPN Staffing Hours per Resident per Day
1.38989
Adjusted RN Staffing Hours per Resident per Day
0.61666
Adjusted Total Nurse Staffing Hours per Resident per Day
4.99600
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-10-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-09-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-11-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
28.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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