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Manorcare Of South Holland - South Holland Nursing Home

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Federal Provider Number
145608
Provider Name
MANORCARE OF SOUTH HOLLAND
Provider Address
2145 EAST 170TH STREET
SOUTH HOLLAND, IL 60473
Provider Phone Number
(708) 895-3255
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
216
Number of Residents in Certified Beds
162
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MANOR CARE OF SOUTH HOLLAND IL LLC
Date First Approved to Provide Medicare and Medicaid services
1989-02-23
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.06296
Reported LPN Staffing Hours per Resident per Day
0.97901
Reported RN Staffing Hours per Resident per Day
1.15154
Reported Licensed Staffing Hours per Resident per Day
2.13056
Reported Total Nurse Staffing Hours per Resident per Day
4.19351
Reported Physical Therapist Staffing Hours per Resident Per Day
0.25278
Expected CNA Staffing Hours per Resident per Day
2.55046
Expected LPN Staffing Hours per Resident per Day
0.73679
Expected RN Staffing Hours per Resident per Day
1.36622
Expected Total Nurse Staffing Hours per Resident per Day
4.65346
Adjusted CNA Staffing Hours per Resident per Day
1.98470
Adjusted LPN Staffing Hours per Resident per Day
1.10286
Adjusted RN Staffing Hours per Resident per Day
0.62979
Adjusted Total Nurse Staffing Hours per Resident per Day
3.63248
Cycle 1 Total Number of Health Deficiencies
23
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
15
Cycle 1 Health Deficiency Score
136
Cycle 1 Standard Survey Health Date
2014-09-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
136
Cycle 2 Total Number of Health Deficiencies
16
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
7
Cycle 2 Health Deficiency Score
88
Cycle 2 Standard Health Survey Date
2013-08-09
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
88
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
8
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-09-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
106.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
55
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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