Foster Health & Rehab Center - Chicago Nursing Home
General Information
UPDATEFederal Provider Number
146167
Provider Name
FOSTER HEALTH & REHAB CENTER
Provider Address
2840 WEST FOSTER AVENUE
CHICAGO, IL 60625
CHICAGO, IL 60625
Provider Phone Number
(773) 561-2040
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
46
Number of Residents in Certified Beds
40
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FOSTER HEALTH & REHABILITATION CENTER LLC
Date First Approved to Provide Medicare and Medicaid services
2014-04-24
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
5
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.29500
Reported LPN Staffing Hours per Resident per Day
0.37250
Reported RN Staffing Hours per Resident per Day
0.53875
Reported Licensed Staffing Hours per Resident per Day
0.91125
Reported Total Nurse Staffing Hours per Resident per Day
2.20625
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.52665
Expected LPN Staffing Hours per Resident per Day
0.65318
Expected RN Staffing Hours per Resident per Day
1.09378
Expected Total Nurse Staffing Hours per Resident per Day
4.27361
Adjusted CNA Staffing Hours per Resident per Day
1.25761
Adjusted LPN Staffing Hours per Resident per Day
0.47334
Adjusted RN Staffing Hours per Resident per Day
0.36804
Adjusted Total Nurse Staffing Hours per Resident per Day
2.08095
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2015-01-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-11-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
0000-00-00
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
8.80000
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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