Glen Saint Andrew Living Comm - Niles Nursing Home
General Information
UPDATEFederal Provider Number
140000000000000000000000000000
Provider Name
GLEN SAINT ANDREW LIVING COMM
Provider Address
7000 NORTH NEWARK
NILES, IL 60714
NILES, IL 60714
Provider Phone Number
(847) 647-8332
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
55
Number of Residents in Certified Beds
42
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1976-05-14
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
With a Resident and Family Council
Resident
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
1.68571
Reported LPN Staffing Hours per Resident per Day
0.30476
Reported RN Staffing Hours per Resident per Day
0.75238
Reported Licensed Staffing Hours per Resident per Day
1.05714
Reported Total Nurse Staffing Hours per Resident per Day
2.74285
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02857
Expected CNA Staffing Hours per Resident per Day
2.58357
Expected LPN Staffing Hours per Resident per Day
0.56213
Expected RN Staffing Hours per Resident per Day
0.75013
Expected Total Nurse Staffing Hours per Resident per Day
3.89584
Adjusted CNA Staffing Hours per Resident per Day
1.60097
Adjusted LPN Staffing Hours per Resident per Day
0.44998
Adjusted RN Staffing Hours per Resident per Day
0.74944
Adjusted Total Nurse Staffing Hours per Resident per Day
2.83794
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-12-24
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
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-01-09
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
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
2013-02-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
22.66700
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
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