Pershing Gardens Healthcare Center - Stickney Nursing Home
General Information
UPDATEFederal Provider Number
146078
Provider Name
PERSHING GARDENS HEALTHCARE CENTER
Provider Address
3900 SOUTH OAK PARK AVENUE
STICKNEY, IL 60402
STICKNEY, IL 60402
Provider Phone Number
(708) 484-7543
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
51
Number of Residents in Certified Beds
43
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PERSHING GARDENS HEALTHCARE CENTER LLC
Date First Approved to Provide Medicare and Medicaid services
2005-04-05
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
2
QM Rating Footnote
Staffing Rating
0
Staffing Rating Footnote
Data Not Available
RN Staffing Rating
0
RN Staffing Rating Footnote
Data Not Available
Reported Staffing Footnote
Staffing Values not Reported because of Data Quality Concerns
Physical Therapist Staffing Footnote
Physical Therapy Staffing Values not Reported because of Data Quality Concerns
Reported CNA Staffing Hours per Resident per Day
0.00000
Reported LPN Staffing Hours per Resident per Day
0.00000
Reported RN Staffing Hours per Resident per Day
0.00000
Reported Licensed Staffing Hours per Resident per Day
0.00000
Reported Total Nurse Staffing Hours per Resident per Day
0.00000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.05650
Expected LPN Staffing Hours per Resident per Day
0.61653
Expected RN Staffing Hours per Resident per Day
1.07539
Expected Total Nurse Staffing Hours per Resident per Day
3.74842
Adjusted CNA Staffing Hours per Resident per Day
0.00000
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
0.00000
Adjusted Total Nurse Staffing Hours per Resident per Day
0.00000
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2015-01-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-12-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
52
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
14
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2012-10-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
30.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
3
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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