Overall Rating
Address
4621 North Racine Avenue
Chicago, IL 60640
Contact
7737842300
Certification Date
2019-02-08
CMS Certification Number
146191
Ownership Type
For profit - Individual
Number of Certified Beds
132
Average Number of Residents per Day
120.4
Provider Type
Medicare and Medicaid
Legal Business Name
4621 CORPORATION
Affiliated Entity Name
Affiliated Entity ID
Health Inspection Rating
3
Quality Measure Rating
3
Staffing Rating
1
Reported Nurse Aide Staffing Hours per Resident per Day
1.42676
Reported LPN Staffing Hours per Resident per Day
0.46232
Reported RN Staffing Hours per Resident per Day
0.43077
Reported Total Nurse Staffing Hours per Resident per Day
2.31986
Total Number of Nurse Staff Hours per Resident per Day on the Weekend
2.19175
Registered Nurse Hours per Resident per Day on the Weekend
0.41443
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02029
Long-Stay Quality Measure Rating
3
Short-Stay Quality Measure Rating
Total Weighted Health Survey Score
68.667
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
6
Number of Citations from Infection Control Inspections
0
Standard Health Survey Date
2023-12-07
Total Number of Health Deficiencies
10
Number of Standard Health Deficiencies
8
Number of Complaint Health Deficiencies
2
Health Deficiency Score
64
Number of Health Revisits
1
Health Revisit Score
0
Total Health Score
64
Standard Health Survey Date
2023-02-08
Total Number of Health Deficiencies
9
Number of Standard Health Deficiencies
8
Number of Complaint Health Deficiencies
2
Health Deficiency Score
68
Number of Health Revisits
1
Health Revisit Score
0
Total Health Score
68
Standard Health Survey Date
2022-04-13
Total Number of Health Deficiencies
11
Number of Standard Health Deficiencies
9
Number of Complaint Health Deficiencies
2
Health Deficiency Score
84
Number of Health Revisits
1
Health Revisit Score
0
Total Health Score
84
Number of Fines
2
Total Amount of Fines in Dollars
23275.38
Number of Payment Denials
1
Total Number of Penalties
3