Community First Medical Center - Chicago Nursing Home

General Information

UPDATE

Federal Provider Number

145548

Provider Name

COMMUNITY FIRST MEDICAL CENTER

Provider Address

5645 WEST ADDISON STREET
CHICAGO, IL 60634

Provider Phone Number

(773) 282-7000

Provider SSA County

141

Provider County Name

Cook

Provider Website

Provider Description

Ownership Type

For profit - Corporation

Number of Certified Beds

Number of Residents in Certified Beds

Provider Type

Medicare

Provider Resides in Hospital

Legal Business Name

Legal Business Name Not Available

Date First Approved to Provide Medicare and Medicaid services

1985-11-12

Continuing Care Retirement Community

Special Focus Facility

Provider Changed Ownership in Last 12 Months

With a Resident and Family Council

None

Automatic Sprinkler Systems in All Required Areas

Yes

Rating Detail Information

Overall Rating

Overall Rating Footnote

Health Inspection Rating

Health Inspection Rating Footnote

QM Rating

QM Rating Footnote

Staffing Rating

Staffing Rating Footnote

RN Staffing Rating

RN Staffing Rating Footnote

Reported Staffing Footnote

Physical Therapist Staffing Footnote

Reported CNA Staffing Hours per Resident per Day

2.05875

Reported LPN Staffing Hours per Resident per Day

0.14875

Reported RN Staffing Hours per Resident per Day

3.05000

Reported Licensed Staffing Hours per Resident per Day

3.19875

Reported Total Nurse Staffing Hours per Resident per Day

5.25750

Reported Physical Therapist Staffing Hours per Resident Per Day

0.77375

Expected CNA Staffing Hours per Resident per Day

2.19586

Expected LPN Staffing Hours per Resident per Day

0.61318

Expected RN Staffing Hours per Resident per Day

1.44819

Expected Total Nurse Staffing Hours per Resident per Day

4.25723

Adjusted CNA Staffing Hours per Resident per Day

2.30049

Adjusted LPN Staffing Hours per Resident per Day

0.20135

Adjusted RN Staffing Hours per Resident per Day

1.57366

Adjusted Total Nurse Staffing Hours per Resident per Day

4.97799

Cycle 1 Total Number of Health Deficiencies

Cycle 1 Number of Standard Health Deficiencies

Cycle 1 Number of Complaint Health Deficiencies

Cycle 1 Health Deficiency Score

Cycle 1 Standard Survey Health Date

2015-03-26

Cycle 1 Number of Health Revisits

Cycle 1 Health Revisit Score

Cycle 1 Total Health Score

Cycle 2 Total Number of Health Deficiencies

Cycle 2 Number of Standard Health Deficiencies

Cycle 2 Number of Complaint Health Deficiencies

Cycle 2 Health Deficiency Score

Cycle 2 Standard Health Survey Date

2014-04-02

Cycle 2 Number of Health Revisits

Cycle 2 Health Revisit Score

Cycle 2 Total Health Score

Cycle 3 Total Number of Health Deficiencies

Cycle 3 Number of Standard Health Deficiencies

Cycle 3 Number of Complaint Health Deficiencies

Cycle 3 Health Deficiency Score

Cycle 3 Standard Health Survey Date

2013-05-03

Cycle 3 Number of Health Revisits

Cycle 3 Health Revisit Score

Cycle 3 Total Health Score

Total Weighted Health Survey Score

36.66700

Number of Facility Reported Incidents

Number of Substantiated Complaints

Number of Fines

Total Amount of Fines in Dollars

Number of Payment Denials

Total Number of Penalties

Location

Processing Date

2015-06-01

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