Swedish Covenant Hospital - Chicago Nursing Home

General Information

UPDATE

Federal Provider Number

145573

Provider Name

SWEDISH COVENANT HOSPITAL

Provider Address

5145 NORTH CALIFORNIA
CHICAGO, IL 60625

Provider Phone Number

(773) 878-8200

Provider SSA County

141

Provider County Name

Cook

Provider Website

Provider Description

Ownership Type

Non profit - Church related

Number of Certified Beds

Number of Residents in Certified Beds

Provider Type

Medicare

Provider Resides in Hospital

Legal Business Name

Legal Business Name Not Available

Date First Approved to Provide Medicare and Medicaid services

1987-04-22

Continuing Care Retirement Community

Special Focus Facility

Provider Changed Ownership in Last 12 Months

With a Resident and Family Council

Resident

Automatic Sprinkler Systems in All Required Areas

Yes

Rating Detail Information

Overall Rating

Overall Rating Footnote

Health Inspection Rating

Health Inspection Rating Footnote

QM Rating

QM Rating Footnote

Staffing Rating

Staffing Rating Footnote

RN Staffing Rating

RN Staffing Rating Footnote

Reported Staffing Footnote

Physical Therapist Staffing Footnote

Reported CNA Staffing Hours per Resident per Day

2.78824

Reported LPN Staffing Hours per Resident per Day

1.41176

Reported RN Staffing Hours per Resident per Day

2.85588

Reported Licensed Staffing Hours per Resident per Day

4.26765

Reported Total Nurse Staffing Hours per Resident per Day

7.05588

Reported Physical Therapist Staffing Hours per Resident Per Day

0.33529

Expected CNA Staffing Hours per Resident per Day

2.23011

Expected LPN Staffing Hours per Resident per Day

0.90500

Expected RN Staffing Hours per Resident per Day

2.10503

Expected Total Nurse Staffing Hours per Resident per Day

5.24015

Adjusted CNA Staffing Hours per Resident per Day

3.06779

Adjusted LPN Staffing Hours per Resident per Day

1.29476

Adjusted RN Staffing Hours per Resident per Day

1.01372

Adjusted Total Nurse Staffing Hours per Resident per Day

5.42762

Cycle 1 Total Number of Health Deficiencies

Cycle 1 Number of Standard Health Deficiencies

Cycle 1 Number of Complaint Health Deficiencies

Cycle 1 Health Deficiency Score

Cycle 1 Standard Survey Health Date

2015-03-12

Cycle 1 Number of Health Revisits

Cycle 1 Health Revisit Score

Cycle 1 Total Health Score

Cycle 2 Total Number of Health Deficiencies

Cycle 2 Number of Standard Health Deficiencies

Cycle 2 Number of Complaint Health Deficiencies

Cycle 2 Health Deficiency Score

Cycle 2 Standard Health Survey Date

2014-01-29

Cycle 2 Number of Health Revisits

Cycle 2 Health Revisit Score

Cycle 2 Total Health Score

Cycle 3 Total Number of Health Deficiencies

Cycle 3 Number of Standard Health Deficiencies

Cycle 3 Number of Complaint Health Deficiencies

Cycle 3 Health Deficiency Score

Cycle 3 Standard Health Survey Date

2012-12-14

Cycle 3 Number of Health Revisits

Cycle 3 Health Revisit Score

Cycle 3 Total Health Score

Total Weighted Health Survey Score

10.66700

Number of Facility Reported Incidents

Number of Substantiated Complaints

Number of Fines

Total Amount of Fines in Dollars

Number of Payment Denials

Total Number of Penalties

Location

Processing Date

2015-06-01

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