Monroe Pav Hlth/treatment Ctr - Chicago Nursing Home
General Information
UPDATEFederal Provider Number
140000000000000000000000000000
Provider Name
MONROE PAV HLTH/TREATMENT CTR
Provider Address
1400 WEST MONROE STREET
CHICAGO, IL 60607
CHICAGO, IL 60607
Provider Phone Number
(312) 666-4090
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
136
Number of Residents in Certified Beds
114
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
1980-06-12
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
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.14605
Reported LPN Staffing Hours per Resident per Day
0.56272
Reported RN Staffing Hours per Resident per Day
0.11009
Reported Licensed Staffing Hours per Resident per Day
0.67281
Reported Total Nurse Staffing Hours per Resident per Day
1.81886
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
1.26959
Expected LPN Staffing Hours per Resident per Day
0.47893
Expected RN Staffing Hours per Resident per Day
0.53210
Expected Total Nurse Staffing Hours per Resident per Day
2.28062
Adjusted CNA Staffing Hours per Resident per Day
2.21494
Adjusted LPN Staffing Hours per Resident per Day
0.97522
Adjusted RN Staffing Hours per Resident per Day
0.15459
Adjusted Total Nurse Staffing Hours per Resident per Day
3.21476
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-09-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-08-08
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
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-10-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
46.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
8
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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