Grove Of Evanston - Evanston Nursing Home
General Information
UPDATEFederal Provider Number
145011
Provider Name
GROVE OF EVANSTON
Provider Address
500 ASBURY STREET
EVANSTON, IL 60202
EVANSTON, IL 60202
Provider Phone Number
(847) 316-3320
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
For profit - Individual
Number of Certified Beds
124
Number of Residents in Certified Beds
86
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GROVE OF EVANSTON LLC
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
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
5
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.02674
Reported LPN Staffing Hours per Resident per Day
0.59128
Reported RN Staffing Hours per Resident per Day
0.83023
Reported Licensed Staffing Hours per Resident per Day
1.42151
Reported Total Nurse Staffing Hours per Resident per Day
3.44825
Reported Physical Therapist Staffing Hours per Resident Per Day
0.66453
Expected CNA Staffing Hours per Resident per Day
2.60232
Expected LPN Staffing Hours per Resident per Day
0.70102
Expected RN Staffing Hours per Resident per Day
1.29950
Expected Total Nurse Staffing Hours per Resident per Day
4.60283
Adjusted CNA Staffing Hours per Resident per Day
1.91099
Adjusted LPN Staffing Hours per Resident per Day
0.70007
Adjusted RN Staffing Hours per Resident per Day
0.47738
Adjusted Total Nurse Staffing Hours per Resident per Day
3.01978
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-11-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2014-01-31
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
5
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2013-02-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
40.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
4
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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