Windsor Park Manor - Carol Stream Nursing Home
General Information
UPDATEFederal Provider Number
145606
Provider Name
WINDSOR PARK MANOR
Provider Address
110 WINDSOR PARK DRIVE
CAROL STREAM, IL 60188
CAROL STREAM, IL 60188
Provider Phone Number
6305105200
Provider SSA County
250
Provider County Name
Du Page
Ownership Type
Non profit - Corporation
Number of Certified Beds
48
Number of Residents in Certified Beds
24
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WINDSOR PARK A COVENANT RETIREMENT COMMUNITY
Date First Approved to Provide Medicare and Medicaid services
1989-03-03
Continuing Care Retirement Community
Y
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
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
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
3.34792
Reported LPN Staffing Hours per Resident per Day
0.00000
Reported RN Staffing Hours per Resident per Day
3.18333
Reported Licensed Staffing Hours per Resident per Day
3.18333
Reported Total Nurse Staffing Hours per Resident per Day
6.53125
Reported Physical Therapist Staffing Hours per Resident Per Day
0.52917
Expected CNA Staffing Hours per Resident per Day
2.36515
Expected LPN Staffing Hours per Resident per Day
0.76712
Expected RN Staffing Hours per Resident per Day
1.66483
Expected Total Nurse Staffing Hours per Resident per Day
4.79710
Adjusted CNA Staffing Hours per Resident per Day
3.47327
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
1.42872
Adjusted Total Nurse Staffing Hours per Resident per Day
5.48807
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2015-03-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2014-02-27
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
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2013-04-19
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
32.66700
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
1
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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