Wesley Place - Chicago Nursing Home
General Information
UPDATEFederal Provider Number
145591
Provider Name
WESLEY PLACE
Provider Address
1415 WEST FOSTER AVENUE
CHICAGO, IL 60640
CHICAGO, IL 60640
Provider Phone Number
(773) 769-5500
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
108
Number of Residents in Certified Beds
77
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CHICAGOLAND METHODIST SENIOR SERVICES
Date First Approved to Provide Medicare and Medicaid services
1988-02-25
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
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
3.06299
Reported LPN Staffing Hours per Resident per Day
0.16234
Reported RN Staffing Hours per Resident per Day
1.88571
Reported Licensed Staffing Hours per Resident per Day
2.04805
Reported Total Nurse Staffing Hours per Resident per Day
5.11104
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.56695
Expected LPN Staffing Hours per Resident per Day
0.67881
Expected RN Staffing Hours per Resident per Day
1.23183
Expected Total Nurse Staffing Hours per Resident per Day
4.47759
Adjusted CNA Staffing Hours per Resident per Day
2.92786
Adjusted LPN Staffing Hours per Resident per Day
0.19850
Adjusted RN Staffing Hours per Resident per Day
1.14383
Adjusted Total Nurse Staffing Hours per Resident per Day
4.60115
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
84
Cycle 1 Standard Survey Health Date
2015-02-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
84
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2014-01-29
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-12-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
57.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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