Columbus Park N & Rehab Center - Chicago Nursing Home
General Information
UPDATEFederal Provider Number
145834
Provider Name
COLUMBUS PARK N & REHAB CENTER
Provider Address
901 SOUTH AUSTIN
CHICAGO, IL 60644
CHICAGO, IL 60644
Provider Phone Number
(773) 287-5959
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
216
Number of Residents in Certified Beds
190
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COLUMBUS PARK NURSING & REHABILITATION CENTER, INC.
Date First Approved to Provide Medicare and Medicaid services
1995-06-01
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
2
Overall Rating Footnote
Health Inspection Rating
3
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
1.23974
Reported LPN Staffing Hours per Resident per Day
0.46579
Reported RN Staffing Hours per Resident per Day
0.21605
Reported Licensed Staffing Hours per Resident per Day
0.68184
Reported Total Nurse Staffing Hours per Resident per Day
1.92158
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04553
Expected CNA Staffing Hours per Resident per Day
1.93645
Expected LPN Staffing Hours per Resident per Day
0.59081
Expected RN Staffing Hours per Resident per Day
0.84478
Expected Total Nurse Staffing Hours per Resident per Day
3.37204
Adjusted CNA Staffing Hours per Resident per Day
1.57089
Adjusted LPN Staffing Hours per Resident per Day
0.65436
Adjusted RN Staffing Hours per Resident per Day
0.19109
Adjusted Total Nurse Staffing Hours per Resident per Day
2.29703
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2015-02-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2014-04-18
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2013-03-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
30.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
6
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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