Center Home Hispanic Elderly - Chicago Nursing Home
General Information
UPDATEFederal Provider Number
146062
Provider Name
CENTER HOME HISPANIC ELDERLY
Provider Address
1401 NORTH CALIFORNIA
CHICAGO, IL 60622
CHICAGO, IL 60622
Provider Phone Number
(773) 782-8700
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
156
Number of Residents in Certified Beds
139
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CENTER HOME FOR HISPANIC ELDERLY, LLC
Date First Approved to Provide Medicare and Medicaid services
2004-06-01
Continuing Care Retirement Community
N
Special Focus Facility
Y
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
3
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.59065
Reported LPN Staffing Hours per Resident per Day
0.74353
Reported RN Staffing Hours per Resident per Day
0.57230
Reported Licensed Staffing Hours per Resident per Day
1.31583
Reported Total Nurse Staffing Hours per Resident per Day
2.90648
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04101
Expected CNA Staffing Hours per Resident per Day
2.54113
Expected LPN Staffing Hours per Resident per Day
0.64508
Expected RN Staffing Hours per Resident per Day
0.98985
Expected Total Nurse Staffing Hours per Resident per Day
4.17605
Adjusted CNA Staffing Hours per Resident per Day
1.53592
Adjusted LPN Staffing Hours per Resident per Day
0.95668
Adjusted RN Staffing Hours per Resident per Day
0.43201
Adjusted Total Nurse Staffing Hours per Resident per Day
2.80546
Cycle 1 Total Number of Health Deficiencies
17
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
13
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2015-03-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
8
Cycle 2 Health Deficiency Score
314
Cycle 2 Standard Health Survey Date
2014-09-23
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
314
Cycle 3 Total Number of Health Deficiencies
16
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
254
Cycle 3 Standard Health Survey Date
2013-12-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
254
Total Weighted Health Survey Score
181.00000
Number of Facility Reported Incidents
7
Number of Substantiated Complaints
28
Number of Fines
2
Total Amount of Fines in Dollars
24960
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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