Selfhelp Home Of Chicago - Chicago Nursing Home
General Information
UPDATEFederal Provider Number
146009
Provider Name
SELFHELP HOME OF CHICAGO
Provider Address
908 WEST ARGYLE STREET
CHICAGO, IL 60640
CHICAGO, IL 60640
Provider Phone Number
(773) 271-0300
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
65
Number of Residents in Certified Beds
65
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
THE SELFHELP HOME INC
Date First Approved to Provide Medicare and Medicaid services
2001-10-03
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
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
2.88615
Reported LPN Staffing Hours per Resident per Day
0.19308
Reported RN Staffing Hours per Resident per Day
1.36846
Reported Licensed Staffing Hours per Resident per Day
1.56154
Reported Total Nurse Staffing Hours per Resident per Day
4.44769
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08769
Expected CNA Staffing Hours per Resident per Day
2.34074
Expected LPN Staffing Hours per Resident per Day
0.56752
Expected RN Staffing Hours per Resident per Day
0.92655
Expected Total Nurse Staffing Hours per Resident per Day
3.83481
Adjusted CNA Staffing Hours per Resident per Day
3.02543
Adjusted LPN Staffing Hours per Resident per Day
0.28238
Adjusted RN Staffing Hours per Resident per Day
1.10357
Adjusted Total Nurse Staffing Hours per Resident per Day
4.67512
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-06-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-05-02
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-07-03
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
8.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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