Providence Palos Heights - Palos Heights Nursing Home

General Information

UPDATE
Federal Provider Number
145681
Provider Name
PROVIDENCE PALOS HEIGHTS
Provider Address
13259 SOUTH CENTRAL AVENUE
PALOS HEIGHTS, IL 60463
Provider Phone Number
(708) 597-1000
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
193
Number of Residents in Certified Beds
121
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
1990-10-01
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
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
2.13636
Reported LPN Staffing Hours per Resident per Day
0.40496
Reported RN Staffing Hours per Resident per Day
1.24917
Reported Licensed Staffing Hours per Resident per Day
1.65413
Reported Total Nurse Staffing Hours per Resident per Day
3.79049
Reported Physical Therapist Staffing Hours per Resident Per Day
0.39545
Expected CNA Staffing Hours per Resident per Day
2.48787
Expected LPN Staffing Hours per Resident per Day
0.68155
Expected RN Staffing Hours per Resident per Day
1.24983
Expected Total Nurse Staffing Hours per Resident per Day
4.41926
Adjusted CNA Staffing Hours per Resident per Day
2.10702
Adjusted LPN Staffing Hours per Resident per Day
0.49316
Adjusted RN Staffing Hours per Resident per Day
0.74680
Adjusted Total Nurse Staffing Hours per Resident per Day
3.45739
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-03-21
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-04-12
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
13
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2012-02-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
54.66700
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
15
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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