Community Care Center - Chicago Nursing Home
General Information
UPDATEFederal Provider Number
146164
Provider Name
COMMUNITY CARE CENTER
Provider Address
4314 SOUTH WABASH AVENUE
CHICAGO, IL 60653
CHICAGO, IL 60653
Provider Phone Number
(773) 538-8300
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
204
Number of Residents in Certified Beds
168
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CC CARE LLC
Date First Approved to Provide Medicare and Medicaid services
2012-11-06
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
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
1.08958
Reported LPN Staffing Hours per Resident per Day
0.46756
Reported RN Staffing Hours per Resident per Day
0.45744
Reported Licensed Staffing Hours per Resident per Day
0.92500
Reported Total Nurse Staffing Hours per Resident per Day
2.01458
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03393
Expected CNA Staffing Hours per Resident per Day
1.94462
Expected LPN Staffing Hours per Resident per Day
0.55206
Expected RN Staffing Hours per Resident per Day
0.79833
Expected Total Nurse Staffing Hours per Resident per Day
3.29501
Adjusted CNA Staffing Hours per Resident per Day
1.37482
Adjusted LPN Staffing Hours per Resident per Day
0.70296
Adjusted RN Staffing Hours per Resident per Day
0.42814
Adjusted Total Nurse Staffing Hours per Resident per Day
2.46450
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
7
Cycle 1 Health Deficiency Score
72
Cycle 1 Standard Survey Health Date
2014-08-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
72
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
8
Cycle 2 Health Deficiency Score
88
Cycle 2 Standard Health Survey Date
2013-10-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
88
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2013-03-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
72.00000
Number of Facility Reported Incidents
6
Number of Substantiated Complaints
19
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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