Admiral At The Lake, The - Chicago Nursing Home
General Information
UPDATEFederal Provider Number
146165
Provider Name
ADMIRAL AT THE LAKE, THE
Provider Address
933 WEST FOSTER AVENUE
CHICAGO, IL 60640
CHICAGO, IL 60640
Provider Phone Number
(773) 654-5121
Provider SSA County
141
Provider County Name
Cook
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
36
Number of Residents in Certified Beds
25
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
THE ADMIRAL AT THE LAKE
Date First Approved to Provide Medicare and Medicaid services
2013-10-01
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
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
3.84000
Reported LPN Staffing Hours per Resident per Day
0.18200
Reported RN Staffing Hours per Resident per Day
1.29200
Reported Licensed Staffing Hours per Resident per Day
1.47400
Reported Total Nurse Staffing Hours per Resident per Day
5.31400
Reported Physical Therapist Staffing Hours per Resident Per Day
0.22800
Expected CNA Staffing Hours per Resident per Day
2.41602
Expected LPN Staffing Hours per Resident per Day
0.67753
Expected RN Staffing Hours per Resident per Day
1.29355
Expected Total Nurse Staffing Hours per Resident per Day
4.38711
Adjusted CNA Staffing Hours per Resident per Day
3.89989
Adjusted LPN Staffing Hours per Resident per Day
0.22296
Adjusted RN Staffing Hours per Resident per Day
0.74630
Adjusted Total Nurse Staffing Hours per Resident per Day
4.88254
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2015-02-27
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
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2014-04-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
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
2013-07-12
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
18.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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