Lake Shore Hlthcare &rehab Ctr - Chicago Nursing Home

General Information

UPDATE

Federal Provider Number

145244

Provider Name

LAKE SHORE HLTHCARE &REHAB CTR

Provider Address

7200 NORTH SHERIDAN ROAD
CHICAGO, IL 60626

Provider Phone Number

(773) 973-7200

Provider SSA County

141

Provider County Name

Cook

Provider Website

Provider Description

Ownership Type

For profit - Individual

Number of Certified Beds

313

Number of Residents in Certified Beds

238

Provider Type

Medicare and Medicaid

Provider Resides in Hospital

Legal Business Name

Legal Business Name Not Available

Date First Approved to Provide Medicare and Medicaid services

1972-05-12

Continuing Care Retirement Community

Special Focus Facility

Provider Changed Ownership in Last 12 Months

With a Resident and Family Council

Resident

Automatic Sprinkler Systems in All Required Areas

Yes

Rating Detail Information

Overall Rating

Overall Rating Footnote

Health Inspection Rating

Health Inspection Rating Footnote

QM Rating

QM Rating Footnote

Staffing Rating

Staffing Rating Footnote

RN Staffing Rating

RN Staffing Rating Footnote

Reported Staffing Footnote

Physical Therapist Staffing Footnote

Reported CNA Staffing Hours per Resident per Day

2.19685

Reported LPN Staffing Hours per Resident per Day

0.27311

Reported RN Staffing Hours per Resident per Day

0.46113

Reported Licensed Staffing Hours per Resident per Day

0.73424

Reported Total Nurse Staffing Hours per Resident per Day

2.93109

Reported Physical Therapist Staffing Hours per Resident Per Day

0.07773

Expected CNA Staffing Hours per Resident per Day

2.47538

Expected LPN Staffing Hours per Resident per Day

0.70691

Expected RN Staffing Hours per Resident per Day

1.15384

Expected Total Nurse Staffing Hours per Resident per Day

4.33613

Adjusted CNA Staffing Hours per Resident per Day

2.17761

Adjusted LPN Staffing Hours per Resident per Day

0.32066

Adjusted RN Staffing Hours per Resident per Day

0.29862

Adjusted Total Nurse Staffing Hours per Resident per Day

2.72476

Cycle 1 Total Number of Health Deficiencies

Cycle 1 Number of Standard Health Deficiencies

Cycle 1 Number of Complaint Health Deficiencies

Cycle 1 Health Deficiency Score

Cycle 1 Standard Survey Health Date

2014-10-10

Cycle 1 Number of Health Revisits

Cycle 1 Health Revisit Score

Cycle 1 Total Health Score

Cycle 2 Total Number of Health Deficiencies

Cycle 2 Number of Standard Health Deficiencies

Cycle 2 Number of Complaint Health Deficiencies

Cycle 2 Health Deficiency Score

367

Cycle 2 Standard Health Survey Date

2014-01-10

Cycle 2 Number of Health Revisits

Cycle 2 Health Revisit Score

Cycle 2 Total Health Score

367

Cycle 3 Total Number of Health Deficiencies

Cycle 3 Number of Standard Health Deficiencies

Cycle 3 Number of Complaint Health Deficiencies

Cycle 3 Health Deficiency Score

Cycle 3 Standard Health Survey Date

2013-01-18

Cycle 3 Number of Health Revisits

Cycle 3 Health Revisit Score

Cycle 3 Total Health Score

Total Weighted Health Survey Score

167.00000

Number of Facility Reported Incidents

Number of Substantiated Complaints

Number of Fines

Total Amount of Fines in Dollars

Number of Payment Denials

Total Number of Penalties

Location

Processing Date

2015-06-01

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