Nursing Home

SMITH VILLAGE

Overall Rating

Cited for abuse

Address

2320 West 113th Place

Chicago, IL 60643

Contact

7734747300

Certification Date

1996-09-16

Details

CMS Certification Number

145904

Ownership Type

Non profit - Corporation

Number of Certified Beds

93

Average Number of Residents per Day

68.1

Provider Type

Medicare and Medicaid

Legal Business Name

WASHINGTON AND JANE SMITH COMMUNITY BEVERLY

Affiliated Entity Name

Affiliated Entity ID

Ratings

Health Inspection Rating

2

Quality Measure Rating

3

Staffing Rating

4

Staffing

Reported Nurse Aide Staffing Hours per Resident per Day

3.44144

Reported LPN Staffing Hours per Resident per Day

0.68732

Reported RN Staffing Hours per Resident per Day

1.11125

Reported Total Nurse Staffing Hours per Resident per Day

5.24001

Total Number of Nurse Staff Hours per Resident per Day on the Weekend

4.78460

Registered Nurse Hours per Resident per Day on the Weekend

0.81191

Reported Physical Therapist Staffing Hours per Resident Per Day

0.08743

Quality Measures

Long-Stay Quality Measure Rating

2

Short-Stay Quality Measure Rating

5

Inspections

Total Weighted Health Survey Score

87.333

Number of Facility Reported Incidents

8

Number of Substantiated Complaints

1

Number of Citations from Infection Control Inspections

Health Inspections

Rating Cycle 1

Standard Health Survey Date

2023-10-20

Total Number of Health Deficiencies

9

Number of Standard Health Deficiencies

5

Number of Complaint Health Deficiencies

4

Health Deficiency Score

88

Number of Health Revisits

1

Health Revisit Score

0

Total Health Score

88

Rating Cycle 2

Standard Health Survey Date

2022-12-08

Total Number of Health Deficiencies

6

Number of Standard Health Deficiencies

4

Number of Complaint Health Deficiencies

3

Health Deficiency Score

88

Number of Health Revisits

1

Health Revisit Score

0

Total Health Score

88

Rating Cycle 3

Standard Health Survey Date

2022-01-21

Total Number of Health Deficiencies

8

Number of Standard Health Deficiencies

6

Number of Complaint Health Deficiencies

2

Health Deficiency Score

84

Number of Health Revisits

1

Health Revisit Score

0

Total Health Score

84

Penalties

Number of Fines

5

Total Amount of Fines in Dollars

173527.50

Number of Payment Denials

2

Total Number of Penalties

7