St Paul's House & Hlth Cr Ctr - Chicago Nursing Home
General Information
UPDATEFederal Provider Number
145767
Provider Name
ST PAUL'S HOUSE & HLTH CR CTR
Provider Address
3800 NORTH CALIFORNIA AVENUE
CHICAGO, IL 60618
CHICAGO, IL 60618
Provider Phone Number
(773) 478-4222
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
110
Number of Residents in Certified Beds
88
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ST. PAULS CORPORATION
Date First Approved to Provide Medicare and Medicaid services
1993-11-01
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
3
Health Inspection Rating Footnote
QM Rating
4
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
2.85114
Reported LPN Staffing Hours per Resident per Day
0.65170
Reported RN Staffing Hours per Resident per Day
1.23125
Reported Licensed Staffing Hours per Resident per Day
1.88295
Reported Total Nurse Staffing Hours per Resident per Day
4.73409
Reported Physical Therapist Staffing Hours per Resident Per Day
0.19716
Expected CNA Staffing Hours per Resident per Day
2.48193
Expected LPN Staffing Hours per Resident per Day
0.63376
Expected RN Staffing Hours per Resident per Day
1.10251
Expected Total Nurse Staffing Hours per Resident per Day
4.21820
Adjusted CNA Staffing Hours per Resident per Day
2.81871
Adjusted LPN Staffing Hours per Resident per Day
0.85349
Adjusted RN Staffing Hours per Resident per Day
0.83445
Adjusted Total Nurse Staffing Hours per Resident per Day
4.52388
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-07-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-09-18
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
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
12
Cycle 3 Standard Health Survey Date
2012-08-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
32.00000
Number of Facility Reported Incidents
1
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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