Skokie Meadows Nursing Center I I - Skokie Nursing Home

General Information

UPDATE
Federal Provider Number
14E572
Provider Name
SKOKIE MEADOWS NURSING CENTER I I
Provider Address
4600 WEST GOLF ROAD
SKOKIE, IL 60076
Provider Phone Number
(847) 679-1157
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
111
Number of Residents in Certified Beds
90
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1977-08-01
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
1
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
0.91111
Reported LPN Staffing Hours per Resident per Day
0.59500
Reported RN Staffing Hours per Resident per Day
0.54778
Reported Licensed Staffing Hours per Resident per Day
1.14278
Reported Total Nurse Staffing Hours per Resident per Day
2.05389
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
1.31531
Expected LPN Staffing Hours per Resident per Day
0.45351
Expected RN Staffing Hours per Resident per Day
0.61195
Expected Total Nurse Staffing Hours per Resident per Day
2.38077
Adjusted CNA Staffing Hours per Resident per Day
1.69967
Adjusted LPN Staffing Hours per Resident per Day
1.08896
Adjusted RN Staffing Hours per Resident per Day
0.66884
Adjusted Total Nurse Staffing Hours per Resident per Day
3.47746
Cycle 1 Total Number of Health Deficiencies
28
Cycle 1 Number of Standard Health Deficiencies
28
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
572
Cycle 1 Standard Survey Health Date
2014-12-08
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
286
Cycle 1 Total Health Score
858
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2014-02-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2013-01-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
439.66700
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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