West Suburban Nursing & Rehab Center - Bloomingdale Nursing Home
General Information
UPDATEFederal Provider Number
145333
Provider Name
WEST SUBURBAN NURSING & REHAB CENTER
Provider Address
311 EDGEWATER DRIVE
BLOOMINGDALE, IL 60108
BLOOMINGDALE, IL 60108
Provider Phone Number
(630) 894-7400
Provider SSA County
250
Provider County Name
Du Page
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
259
Number of Residents in Certified Beds
192
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WEST SUBURBAN NURSING AND REHABILITATION CENTER LLC
Date First Approved to Provide Medicare and Medicaid services
1978-02-01
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
2
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
1.68333
Reported LPN Staffing Hours per Resident per Day
0.47240
Reported RN Staffing Hours per Resident per Day
0.74089
Reported Licensed Staffing Hours per Resident per Day
1.21328
Reported Total Nurse Staffing Hours per Resident per Day
2.89662
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05964
Expected CNA Staffing Hours per Resident per Day
2.45782
Expected LPN Staffing Hours per Resident per Day
0.67283
Expected RN Staffing Hours per Resident per Day
1.11948
Expected Total Nurse Staffing Hours per Resident per Day
4.25012
Adjusted CNA Staffing Hours per Resident per Day
1.68051
Adjusted LPN Staffing Hours per Resident per Day
0.58275
Adjusted RN Staffing Hours per Resident per Day
0.49451
Adjusted Total Nurse Staffing Hours per Resident per Day
2.74721
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
88
Cycle 1 Standard Survey Health Date
2014-09-17
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
7
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-11-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2012-12-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
66.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
9
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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