Windmill Nursing Pavilion - South Holland Nursing Home
General Information
UPDATEFederal Provider Number
145927
Provider Name
WINDMILL NURSING PAVILION
Provider Address
16000 SOUTH WABASH
SOUTH HOLLAND, IL 60473
SOUTH HOLLAND, IL 60473
Provider Phone Number
(708) 339-0600
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
150
Number of Residents in Certified Beds
115
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WINDMILL NURSING PAVILION, LTD.
Date First Approved to Provide Medicare and Medicaid services
1997-05-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
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
1.79348
Reported LPN Staffing Hours per Resident per Day
0.62870
Reported RN Staffing Hours per Resident per Day
0.55609
Reported Licensed Staffing Hours per Resident per Day
1.18478
Reported Total Nurse Staffing Hours per Resident per Day
2.97827
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05957
Expected CNA Staffing Hours per Resident per Day
2.37987
Expected LPN Staffing Hours per Resident per Day
0.54940
Expected RN Staffing Hours per Resident per Day
0.88877
Expected Total Nurse Staffing Hours per Resident per Day
3.81804
Adjusted CNA Staffing Hours per Resident per Day
1.84912
Adjusted LPN Staffing Hours per Resident per Day
0.94981
Adjusted RN Staffing Hours per Resident per Day
0.46751
Adjusted Total Nurse Staffing Hours per Resident per Day
3.14432
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
32
Cycle 1 Standard Survey Health Date
2014-10-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-11-22
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
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
40
Cycle 3 Standard Health Survey Date
2012-12-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
32.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
7
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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