Providence Downers Grove - Downers Grove Nursing Home
General Information
UPDATEFederal Provider Number
145657
Provider Name
PROVIDENCE DOWNERS GROVE
Provider Address
3450 SARATOGA AVENUE
DOWNERS GROVE, IL 60515
DOWNERS GROVE, IL 60515
Provider Phone Number
6309692900
Provider SSA County
250
Provider County Name
Du Page
Ownership Type
Non profit - Corporation
Number of Certified Beds
145
Number of Residents in Certified Beds
96
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1989-08-22
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
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
1.77031
Reported LPN Staffing Hours per Resident per Day
0.30208
Reported RN Staffing Hours per Resident per Day
1.32604
Reported Licensed Staffing Hours per Resident per Day
1.62813
Reported Total Nurse Staffing Hours per Resident per Day
3.39843
Reported Physical Therapist Staffing Hours per Resident Per Day
0.44063
Expected CNA Staffing Hours per Resident per Day
2.38230
Expected LPN Staffing Hours per Resident per Day
0.76537
Expected RN Staffing Hours per Resident per Day
1.54785
Expected Total Nurse Staffing Hours per Resident per Day
4.69552
Adjusted CNA Staffing Hours per Resident per Day
1.82337
Adjusted LPN Staffing Hours per Resident per Day
0.32759
Adjusted RN Staffing Hours per Resident per Day
0.64013
Adjusted Total Nurse Staffing Hours per Resident per Day
2.91741
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
72
Cycle 1 Standard Survey Health Date
2015-01-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
72
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2013-12-19
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
6
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2013-02-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
62.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
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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