Oak Trace - Downers Grove Nursing Home
General Information
UPDATEFederal Provider Number
145804
Provider Name
OAK TRACE
Provider Address
250 VILLAGE DRIVE
DOWNERS GROVE, IL 60516
DOWNERS GROVE, IL 60516
Provider Phone Number
6307696200
Provider SSA County
250
Provider County Name
Du Page
Ownership Type
Non profit - Other
Number of Certified Beds
50
Number of Residents in Certified Beds
38
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
LIFESPACE DG, LLC
Date First Approved to Provide Medicare and Medicaid services
1994-09-01
Continuing Care Retirement Community
Y
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
5
QM Rating Footnote
Staffing Rating
3
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
2.18947
Reported LPN Staffing Hours per Resident per Day
0.00000
Reported RN Staffing Hours per Resident per Day
1.93026
Reported Licensed Staffing Hours per Resident per Day
1.93026
Reported Total Nurse Staffing Hours per Resident per Day
4.11973
Reported Physical Therapist Staffing Hours per Resident Per Day
0.26184
Expected CNA Staffing Hours per Resident per Day
2.30442
Expected LPN Staffing Hours per Resident per Day
0.73818
Expected RN Staffing Hours per Resident per Day
1.59187
Expected Total Nurse Staffing Hours per Resident per Day
4.63446
Adjusted CNA Staffing Hours per Resident per Day
2.33131
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
0.90604
Adjusted Total Nurse Staffing Hours per Resident per Day
3.58320
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-08-29
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
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-10-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-11-16
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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