Little Sisters Of The Poor - Chicago Nursing Home
General Information
UPDATEFederal Provider Number
14A289
Provider Name
LITTLE SISTERS OF THE POOR
Provider Address
2325 NORTH LAKEWOOD AVENUE
CHICAGO, IL 60614
CHICAGO, IL 60614
Provider Phone Number
(773) 935-9600
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
76
Number of Residents in Certified Beds
70
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
1980-05-01
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
5
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
2.88929
Reported LPN Staffing Hours per Resident per Day
0.50571
Reported RN Staffing Hours per Resident per Day
0.84857
Reported Licensed Staffing Hours per Resident per Day
1.35429
Reported Total Nurse Staffing Hours per Resident per Day
4.24357
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01643
Expected CNA Staffing Hours per Resident per Day
2.25043
Expected LPN Staffing Hours per Resident per Day
0.58929
Expected RN Staffing Hours per Resident per Day
0.73090
Expected Total Nurse Staffing Hours per Resident per Day
3.57062
Adjusted CNA Staffing Hours per Resident per Day
3.15026
Adjusted LPN Staffing Hours per Resident per Day
0.71228
Adjusted RN Staffing Hours per Resident per Day
0.86750
Adjusted Total Nurse Staffing Hours per Resident per Day
4.79060
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2015-01-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2014-03-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2013-02-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
24.66700
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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