Forest View Rehab & Nursing Center - Itasca Nursing Home
General Information
UPDATEFederal Provider Number
145752
Provider Name
FOREST VIEW REHAB & NURSING CENTER
Provider Address
535 SOUTH ELM
ITASCA, IL 60143
ITASCA, IL 60143
Provider Phone Number
(630) 773-9416
Provider SSA County
250
Provider County Name
Du Page
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
144
Number of Residents in Certified Beds
98
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FOREST VIEW REHABILITATION AND NURSING CENTER
Date First Approved to Provide Medicare and Medicaid services
1993-05-07
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
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
2.71582
Reported LPN Staffing Hours per Resident per Day
0.55102
Reported RN Staffing Hours per Resident per Day
1.19235
Reported Licensed Staffing Hours per Resident per Day
1.74337
Reported Total Nurse Staffing Hours per Resident per Day
4.45919
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08724
Expected CNA Staffing Hours per Resident per Day
2.67208
Expected LPN Staffing Hours per Resident per Day
0.68491
Expected RN Staffing Hours per Resident per Day
1.11445
Expected Total Nurse Staffing Hours per Resident per Day
4.47143
Adjusted CNA Staffing Hours per Resident per Day
2.49387
Adjusted LPN Staffing Hours per Resident per Day
0.66775
Adjusted RN Staffing Hours per Resident per Day
0.79943
Adjusted Total Nurse Staffing Hours per Resident per Day
4.01986
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2015-04-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
202
Cycle 2 Standard Health Survey Date
2014-03-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
202
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
144
Cycle 3 Standard Health Survey Date
2013-05-09
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
72
Cycle 3 Total Health Score
216
Total Weighted Health Survey Score
123.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
14
Number of Fines
1
Total Amount of Fines in Dollars
70760
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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