Illinois Nursing Homes >> Evergreen Park Nursing Homes >> Villa At Evergreen Park,the

Villa At Evergreen Park,the - Evergreen Park Nursing Home

General Information

UPDATE
Federal Provider Number
145734
Provider Name
VILLA AT EVERGREEN PARK,THE
Provider Address
10124 SOUTH KEDZIE
EVERGREEN PARK, IL 60805
Provider Phone Number
7089077000
Provider SSA County
141
Provider County Name
Cook
Ownership Type
For profit - Partnership
Number of Certified Beds
242
Number of Residents in Certified Beds
151
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EVERGREEN LIVING & REHAB CENTER, LLC
Date First Approved to Provide Medicare and Medicaid services
1992-07-15
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.67649
Reported LPN Staffing Hours per Resident per Day
0.74404
Reported RN Staffing Hours per Resident per Day
0.93411
Reported Licensed Staffing Hours per Resident per Day
1.67815
Reported Total Nurse Staffing Hours per Resident per Day
3.35464
Reported Physical Therapist Staffing Hours per Resident Per Day
0.22881
Expected CNA Staffing Hours per Resident per Day
2.35892
Expected LPN Staffing Hours per Resident per Day
0.69692
Expected RN Staffing Hours per Resident per Day
1.36360
Expected Total Nurse Staffing Hours per Resident per Day
4.41944
Adjusted CNA Staffing Hours per Resident per Day
1.74385
Adjusted LPN Staffing Hours per Resident per Day
0.88611
Adjusted RN Staffing Hours per Resident per Day
0.51186
Adjusted Total Nurse Staffing Hours per Resident per Day
3.05971
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
9
Cycle 1 Health Deficiency Score
88
Cycle 1 Standard Survey Health Date
2015-03-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
88
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
7
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2014-05-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2013-04-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
64.66700
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
21
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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