St Joseph Village Of Chicago - Chicago Nursing Home
General Information
UPDATEFederal Provider Number
145637
Provider Name
ST JOSEPH VILLAGE OF CHICAGO
Provider Address
4021 WEST BELMONT
CHICAGO, IL 60641
CHICAGO, IL 60641
Provider Phone Number
(773) 328-5500
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
54
Number of Residents in Certified Beds
50
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
FRANCISCAN COMMUNITIES, INC
Date First Approved to Provide Medicare and Medicaid services
1989-08-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
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
2.24000
Reported LPN Staffing Hours per Resident per Day
0.28900
Reported RN Staffing Hours per Resident per Day
1.39700
Reported Licensed Staffing Hours per Resident per Day
1.68600
Reported Total Nurse Staffing Hours per Resident per Day
3.92600
Reported Physical Therapist Staffing Hours per Resident Per Day
0.22900
Expected CNA Staffing Hours per Resident per Day
2.59630
Expected LPN Staffing Hours per Resident per Day
0.66665
Expected RN Staffing Hours per Resident per Day
1.03633
Expected Total Nurse Staffing Hours per Resident per Day
4.29928
Adjusted CNA Staffing Hours per Resident per Day
2.11697
Adjusted LPN Staffing Hours per Resident per Day
0.35981
Adjusted RN Staffing Hours per Resident per Day
1.00725
Adjusted Total Nurse Staffing Hours per Resident per Day
3.68093
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2015-03-19
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2014-05-01
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2013-06-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
14.66700
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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