Courtyard Healthcare Center - Berwyn Nursing Home
General Information
UPDATEFederal Provider Number
145070
Provider Name
COURTYARD HEALTHCARE CENTER
Provider Address
3601 SOUTH HARLEM AVENUE
BERWYN, IL 60402
BERWYN, IL 60402
Provider Phone Number
7087494160
Provider SSA County
141
Provider County Name
Cook
Ownership Type
For profit - Partnership
Number of Certified Beds
145
Number of Residents in Certified Beds
115
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COURTYARD HEALTHCARE CENTER LLC
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
1
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
1.76087
Reported LPN Staffing Hours per Resident per Day
0.90261
Reported RN Staffing Hours per Resident per Day
0.34739
Reported Licensed Staffing Hours per Resident per Day
1.25000
Reported Total Nurse Staffing Hours per Resident per Day
3.01087
Reported Physical Therapist Staffing Hours per Resident Per Day
0.13174
Expected CNA Staffing Hours per Resident per Day
2.52639
Expected LPN Staffing Hours per Resident per Day
0.64207
Expected RN Staffing Hours per Resident per Day
0.96561
Expected Total Nurse Staffing Hours per Resident per Day
4.13407
Adjusted CNA Staffing Hours per Resident per Day
1.71021
Adjusted LPN Staffing Hours per Resident per Day
1.16679
Adjusted RN Staffing Hours per Resident per Day
0.26881
Adjusted Total Nurse Staffing Hours per Resident per Day
2.93573
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
7
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2015-03-13
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
14
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
7
Cycle 2 Health Deficiency Score
167
Cycle 2 Standard Health Survey Date
2014-05-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
8
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2013-04-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
96.33300
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
31
Number of Fines
1
Total Amount of Fines in Dollars
10078
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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