Church Creek - Arlington Hts Nursing Home
General Information
UPDATEFederal Provider Number
145640
Provider Name
CHURCH CREEK
Provider Address
1200 WEST CENTRAL ROAD
ARLINGTON HTS, IL 60005
ARLINGTON HTS, IL 60005
Provider Phone Number
(847) 506-3200
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
56
Number of Residents in Certified Beds
43
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
SNH SE TENANT TRS, INC.
Date First Approved to Provide Medicare and Medicaid services
1989-03-28
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
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
1.83837
Reported LPN Staffing Hours per Resident per Day
0.51279
Reported RN Staffing Hours per Resident per Day
1.03837
Reported Licensed Staffing Hours per Resident per Day
1.55116
Reported Total Nurse Staffing Hours per Resident per Day
3.38953
Reported Physical Therapist Staffing Hours per Resident Per Day
0.24884
Expected CNA Staffing Hours per Resident per Day
2.32415
Expected LPN Staffing Hours per Resident per Day
0.66117
Expected RN Staffing Hours per Resident per Day
1.36659
Expected Total Nurse Staffing Hours per Resident per Day
4.35191
Adjusted CNA Staffing Hours per Resident per Day
1.94084
Adjusted LPN Staffing Hours per Resident per Day
0.64373
Adjusted RN Staffing Hours per Resident per Day
0.56774
Adjusted Total Nurse Staffing Hours per Resident per Day
3.13951
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-07-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-09-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-10-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
34.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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