Presence Pine View Care Center - St Charles Nursing Home
General Information
UPDATEFederal Provider Number
145433
Provider Name
PRESENCE PINE VIEW CARE CENTER
Provider Address
611 ALLEN LANE
ST CHARLES, IL 60174
ST CHARLES, IL 60174
Provider Phone Number
(630) 377-2211
Provider SSA County
530
Provider County Name
Kane
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
120
Number of Residents in Certified Beds
94
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PRESENCE LIFE CONNECTIONS
Date First Approved to Provide Medicare and Medicaid services
1981-08-31
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.12819
Reported LPN Staffing Hours per Resident per Day
0.35160
Reported RN Staffing Hours per Resident per Day
0.91170
Reported Licensed Staffing Hours per Resident per Day
1.26330
Reported Total Nurse Staffing Hours per Resident per Day
3.39149
Reported Physical Therapist Staffing Hours per Resident Per Day
0.13617
Expected CNA Staffing Hours per Resident per Day
2.34724
Expected LPN Staffing Hours per Resident per Day
0.63055
Expected RN Staffing Hours per Resident per Day
1.06637
Expected Total Nurse Staffing Hours per Resident per Day
4.04417
Adjusted CNA Staffing Hours per Resident per Day
2.22471
Adjusted LPN Staffing Hours per Resident per Day
0.46281
Adjusted RN Staffing Hours per Resident per Day
0.63882
Adjusted Total Nurse Staffing Hours per Resident per Day
3.38036
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-09-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
147
Cycle 2 Standard Health Survey Date
2013-07-31
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
147
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2012-08-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
75.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
3
Number of Fines
2
Total Amount of Fines in Dollars
13650
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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