Nazarethville - Des Plaines Nursing Home
General Information
UPDATEFederal Provider Number
14E620
Provider Name
NAZARETHVILLE
Provider Address
300 NORTH RIVER ROAD
DES PLAINES, IL 60016
DES PLAINES, IL 60016
Provider Phone Number
(847) 297-5900
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
68
Number of Residents in Certified Beds
67
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
1974-03-31
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
2.21343
Reported LPN Staffing Hours per Resident per Day
0.21866
Reported RN Staffing Hours per Resident per Day
0.91269
Reported Licensed Staffing Hours per Resident per Day
1.13134
Reported Total Nurse Staffing Hours per Resident per Day
3.34478
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01716
Expected CNA Staffing Hours per Resident per Day
2.46157
Expected LPN Staffing Hours per Resident per Day
0.51939
Expected RN Staffing Hours per Resident per Day
0.68581
Expected Total Nurse Staffing Hours per Resident per Day
3.66676
Adjusted CNA Staffing Hours per Resident per Day
2.20635
Adjusted LPN Staffing Hours per Resident per Day
0.34943
Adjusted RN Staffing Hours per Resident per Day
0.99439
Adjusted Total Nurse Staffing Hours per Resident per Day
3.67694
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-10-16
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-12-05
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-11-09
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
2.66700
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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