Fairmont Care Centre - Chicago Nursing Home
General Information
UPDATEFederal Provider Number
145867
Provider Name
FAIRMONT CARE CENTRE
Provider Address
5061 NORTH PULASKI ROAD
CHICAGO, IL 60630
CHICAGO, IL 60630
Provider Phone Number
(773) 604-8112
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
186
Number of Residents in Certified Beds
134
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FAIRMONT CARE CENTRE, INC.
Date First Approved to Provide Medicare and Medicaid services
1996-02-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.37388
Reported LPN Staffing Hours per Resident per Day
0.54851
Reported RN Staffing Hours per Resident per Day
1.13955
Reported Licensed Staffing Hours per Resident per Day
1.68806
Reported Total Nurse Staffing Hours per Resident per Day
4.06194
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08582
Expected CNA Staffing Hours per Resident per Day
2.77641
Expected LPN Staffing Hours per Resident per Day
0.67875
Expected RN Staffing Hours per Resident per Day
1.06504
Expected Total Nurse Staffing Hours per Resident per Day
4.52020
Adjusted CNA Staffing Hours per Resident per Day
2.09796
Adjusted LPN Staffing Hours per Resident per Day
0.67074
Adjusted RN Staffing Hours per Resident per Day
0.79947
Adjusted Total Nurse Staffing Hours per Resident per Day
3.62225
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
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
16
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
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
8
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-08-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
13.33300
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
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