Rolling Hills Manor - Zion Nursing Home
General Information
UPDATEFederal Provider Number
145443
Provider Name
ROLLING HILLS MANOR
Provider Address
3615 16TH STREET
ZION, IL 60099
ZION, IL 60099
Provider Phone Number
8477468382
Provider SSA County
570
Provider County Name
Lake
Ownership Type
Non profit - Other
Number of Certified Beds
115
Number of Residents in Certified Beds
98
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
SLOVAK AMERICAN CHARITABLE ASSOCIATION
Date First Approved to Provide Medicare and Medicaid services
1982-03-22
Continuing Care Retirement Community
Y
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
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
3.24439
Reported LPN Staffing Hours per Resident per Day
0.84439
Reported RN Staffing Hours per Resident per Day
1.03265
Reported Licensed Staffing Hours per Resident per Day
1.87704
Reported Total Nurse Staffing Hours per Resident per Day
5.12143
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11071
Expected CNA Staffing Hours per Resident per Day
2.46471
Expected LPN Staffing Hours per Resident per Day
0.63587
Expected RN Staffing Hours per Resident per Day
1.10517
Expected Total Nurse Staffing Hours per Resident per Day
4.20574
Adjusted CNA Staffing Hours per Resident per Day
3.22989
Adjusted LPN Staffing Hours per Resident per Day
1.10219
Adjusted RN Staffing Hours per Resident per Day
0.69817
Adjusted Total Nurse Staffing Hours per Resident per Day
4.90852
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
8
Cycle 1 Standard Survey Health Date
2015-01-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-11-22
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
7
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2013-01-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
15.33300
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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