Tri-state Nursing & Rehab Ctr - Lansing Nursing Home

General Information

UPDATE
Federal Provider Number
145879
Provider Name
TRI-STATE NURSING & REHAB CTR
Provider Address
2500 EAST 175TH STREET
LANSING, IL 60438
Provider Phone Number
(708) 474-7330
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
84
Number of Residents in Certified Beds
71
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TRI-STATE NURSING & REHABILITATION CENTER INC
Date First Approved to Provide Medicare and Medicaid services
1996-05-01
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
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
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
2.00775
Reported LPN Staffing Hours per Resident per Day
0.66127
Reported RN Staffing Hours per Resident per Day
0.80493
Reported Licensed Staffing Hours per Resident per Day
1.46620
Reported Total Nurse Staffing Hours per Resident per Day
3.47395
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08028
Expected CNA Staffing Hours per Resident per Day
2.57827
Expected LPN Staffing Hours per Resident per Day
0.66088
Expected RN Staffing Hours per Resident per Day
1.07572
Expected Total Nurse Staffing Hours per Resident per Day
4.31487
Adjusted CNA Staffing Hours per Resident per Day
1.91075
Adjusted LPN Staffing Hours per Resident per Day
0.83050
Adjusted RN Staffing Hours per Resident per Day
0.55911
Adjusted Total Nurse Staffing Hours per Resident per Day
3.24533
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-07-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
76
Cycle 2 Standard Health Survey Date
2013-06-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
76
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
6
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2012-07-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
52.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
13
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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