Lake Park Center - Waukegan Nursing Home
General Information
UPDATEFederal Provider Number
14E882
Provider Name
LAKE PARK CENTER
Provider Address
919 WASHINGTON PARK
WAUKEGAN, IL 60085
WAUKEGAN, IL 60085
Provider Phone Number
(847) 623-9100
Provider SSA County
570
Provider County Name
Lake
Provider Website
Provider Description
Ownership Type
For profit - Partnership
Number of Certified Beds
210
Number of Residents in Certified Beds
179
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1990-05-20
Continuing Care Retirement Community
N
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
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
1.11201
Reported LPN Staffing Hours per Resident per Day
0.19916
Reported RN Staffing Hours per Resident per Day
0.34302
Reported Licensed Staffing Hours per Resident per Day
0.54218
Reported Total Nurse Staffing Hours per Resident per Day
1.65419
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
1.39660
Expected LPN Staffing Hours per Resident per Day
0.44181
Expected RN Staffing Hours per Resident per Day
0.59281
Expected Total Nurse Staffing Hours per Resident per Day
2.43123
Adjusted CNA Staffing Hours per Resident per Day
1.95370
Adjusted LPN Staffing Hours per Resident per Day
0.37415
Adjusted RN Staffing Hours per Resident per Day
0.43235
Adjusted Total Nurse Staffing Hours per Resident per Day
2.74260
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2015-01-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
108
Cycle 2 Standard Health Survey Date
2014-02-18
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
108
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2013-03-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
48.66700
Number of Facility Reported Incidents
3
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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