Hillcrest Retirement Village - Round Lake Beach Nursing Home
General Information
UPDATEFederal Provider Number
146130
Provider Name
HILLCREST RETIREMENT VILLAGE
Provider Address
1740 NORTH CIRCUIT DRIVE
ROUND LAKE BEACH, IL 60073
ROUND LAKE BEACH, IL 60073
Provider Phone Number
8475465300
Provider SSA County
570
Provider County Name
Lake
Ownership Type
For profit - Corporation
Number of Certified Beds
144
Number of Residents in Certified Beds
119
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HILLCREST RETIREMENT VILLAGE LTD
Date First Approved to Provide Medicare and Medicaid services
2009-02-01
Continuing Care Retirement Community
N
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
2
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
1
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
1.71933
Reported LPN Staffing Hours per Resident per Day
0.47689
Reported RN Staffing Hours per Resident per Day
0.54118
Reported Licensed Staffing Hours per Resident per Day
1.01807
Reported Total Nurse Staffing Hours per Resident per Day
2.73740
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04790
Expected CNA Staffing Hours per Resident per Day
2.75748
Expected LPN Staffing Hours per Resident per Day
0.60573
Expected RN Staffing Hours per Resident per Day
0.90859
Expected Total Nurse Staffing Hours per Resident per Day
4.27181
Adjusted CNA Staffing Hours per Resident per Day
1.52992
Adjusted LPN Staffing Hours per Resident per Day
0.65345
Adjusted RN Staffing Hours per Resident per Day
0.44505
Adjusted Total Nurse Staffing Hours per Resident per Day
2.58303
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-10-08
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
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2013-11-13
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
10
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
44
Cycle 3 Standard Health Survey Date
2012-09-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
44.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
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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