Fair Oaks Health Care Center - Crystal Lake Nursing Home
General Information
UPDATEFederal Provider Number
145917
Provider Name
FAIR OAKS HEALTH CARE CENTER
Provider Address
471 TERRA COTTA AVENUE
CRYSTAL LAKE, IL 60014
CRYSTAL LAKE, IL 60014
Provider Phone Number
8154550550
Provider SSA County
640
Provider County Name
Mc Henry
Ownership Type
Non profit - Corporation
Number of Certified Beds
51
Number of Residents in Certified Beds
44
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WISCONSIN ILLINOIS SENIOR HOUSING INC
Date First Approved to Provide Medicare and Medicaid services
1996-12-19
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
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
2.64432
Reported LPN Staffing Hours per Resident per Day
0.85568
Reported RN Staffing Hours per Resident per Day
1.01364
Reported Licensed Staffing Hours per Resident per Day
1.86932
Reported Total Nurse Staffing Hours per Resident per Day
4.51364
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12955
Expected CNA Staffing Hours per Resident per Day
2.43943
Expected LPN Staffing Hours per Resident per Day
0.65930
Expected RN Staffing Hours per Resident per Day
1.16703
Expected Total Nurse Staffing Hours per Resident per Day
4.26576
Adjusted CNA Staffing Hours per Resident per Day
2.65979
Adjusted LPN Staffing Hours per Resident per Day
1.07722
Adjusted RN Staffing Hours per Resident per Day
0.64899
Adjusted Total Nurse Staffing Hours per Resident per Day
4.26513
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
28
Cycle 1 Standard Survey Health Date
2014-04-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
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
48
Cycle 2 Standard Health Survey Date
2013-07-18
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
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-06-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
38.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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
Nursiong Homes Nearby
Crystal Pines Rehab & Hcc
335 North Illinois Avenue |
CRYSTAL LAKE IL 60014 | 0.5 mile away
Springs At Crystal Lake, The
1000 East Brighton Lane |
CRYSTAL LAKE IL 60012 | 1.7 miles away
Alden Terrace Of Mchenry Rehab
803 Royal Drive |
MCHENRY IL 60050 | 6.3 miles away
Crossroads Care Ctr Woodstock
309 Mchenry Avenue |
WOODSTOCK IL 60098 | 8.7 miles away
Hearthstone Manor
920 N Seminary Ave P O Box 520 |
WOODSTOCK IL 60098 | 8.8 miles away
Valley Hi Nursing Home
2406 Hartland Road |
WOODSTOCK IL 60098 | 13 miles away
Florence Nursing Home
546 East Grant Highway |
MARENGO IL 60152 | 15.3 miles away
Mercy Harvard Hospital Care Center
901 South Grant P O Box 850 |
HARVARD IL 60033 | 19.8 miles away
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