Meadowbrook Manor - Lagrange - La Grange Nursing Home
General Information
UPDATEFederal Provider Number
146093
Provider Name
MEADOWBROOK MANOR - LAGRANGE
Provider Address
339 9TH AVENUE
LA GRANGE, IL 60525
LA GRANGE, IL 60525
Provider Phone Number
(708) 354-4660
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
197
Number of Residents in Certified Beds
131
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
BUTTERFIELD HEALTH CARE VII, LLC
Date First Approved to Provide Medicare and Medicaid services
2005-10-31
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
3
Overall Rating Footnote
Health Inspection Rating
2
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
1.91947
Reported LPN Staffing Hours per Resident per Day
0.80420
Reported RN Staffing Hours per Resident per Day
0.65687
Reported Licensed Staffing Hours per Resident per Day
1.46107
Reported Total Nurse Staffing Hours per Resident per Day
3.38054
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14160
Expected CNA Staffing Hours per Resident per Day
2.75607
Expected LPN Staffing Hours per Resident per Day
0.68180
Expected RN Staffing Hours per Resident per Day
1.08019
Expected Total Nurse Staffing Hours per Resident per Day
4.51806
Adjusted CNA Staffing Hours per Resident per Day
1.70889
Adjusted LPN Staffing Hours per Resident per Day
0.97900
Adjusted RN Staffing Hours per Resident per Day
0.45438
Adjusted Total Nurse Staffing Hours per Resident per Day
3.01604
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2014-06-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
36
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
36
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2012-07-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
58.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
6
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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