Pine Crest Health Care - Hazel Crest Nursing Home
General Information
UPDATEFederal Provider Number
145220
Provider Name
PINE CREST HEALTH CARE
Provider Address
3300 WEST 175TH STREET
HAZEL CREST, IL 60429
HAZEL CREST, IL 60429
Provider Phone Number
(708) 335-2400
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
199
Number of Residents in Certified Beds
178
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PINE CREST HEALTH CARE LLC
Date First Approved to Provide Medicare and Medicaid services
1979-12-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
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
1.16770
Reported LPN Staffing Hours per Resident per Day
0.57388
Reported RN Staffing Hours per Resident per Day
0.21208
Reported Licensed Staffing Hours per Resident per Day
0.78596
Reported Total Nurse Staffing Hours per Resident per Day
1.95366
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.05390
Expected LPN Staffing Hours per Resident per Day
0.58124
Expected RN Staffing Hours per Resident per Day
0.81416
Expected Total Nurse Staffing Hours per Resident per Day
3.44930
Adjusted CNA Staffing Hours per Resident per Day
1.39499
Adjusted LPN Staffing Hours per Resident per Day
0.81949
Adjusted RN Staffing Hours per Resident per Day
0.19464
Adjusted Total Nurse Staffing Hours per Resident per Day
2.28307
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-08-22
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2013-09-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
56
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-12-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
35.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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