West Chicago Terrace Nh - West Chicago Nursing Home
General Information
UPDATEFederal Provider Number
14E392
Provider Name
WEST CHICAGO TERRACE NH
Provider Address
928 JOLIET ROAD
WEST CHICAGO, IL 60185
WEST CHICAGO, IL 60185
Provider Phone Number
6302319292
Provider SSA County
250
Provider County Name
Du Page
Ownership Type
For profit - Partnership
Number of Certified Beds
120
Number of Residents in Certified Beds
118
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1976-04-14
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
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.79958
Reported LPN Staffing Hours per Resident per Day
0.28814
Reported RN Staffing Hours per Resident per Day
0.33051
Reported Licensed Staffing Hours per Resident per Day
0.61864
Reported Total Nurse Staffing Hours per Resident per Day
3.41823
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03644
Expected CNA Staffing Hours per Resident per Day
1.73660
Expected LPN Staffing Hours per Resident per Day
0.49193
Expected RN Staffing Hours per Resident per Day
0.65324
Expected Total Nurse Staffing Hours per Resident per Day
2.88177
Adjusted CNA Staffing Hours per Resident per Day
3.95563
Adjusted LPN Staffing Hours per Resident per Day
0.48616
Adjusted RN Staffing Hours per Resident per Day
0.37805
Adjusted Total Nurse Staffing Hours per Resident per Day
4.78128
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
6
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2014-06-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
18
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
11
Cycle 2 Health Deficiency Score
112
Cycle 2 Standard Health Survey Date
2013-05-02
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
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2012-05-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
80.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
14
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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