Lake Shore Hlthcare &rehab Ctr - Chicago Nursing Home
General Information
UPDATEFederal Provider Number
145244
Provider Name
LAKE SHORE HLTHCARE &REHAB CTR
Provider Address
7200 NORTH SHERIDAN ROAD
CHICAGO, IL 60626
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
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1972-05-12
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
2
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
15
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
7
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2014-10-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
80
Cycle 2 Total Number of Health Deficiencies
35
Cycle 2 Number of Standard Health Deficiencies
30
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
367
Cycle 2 Standard Health Survey Date
2014-01-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
367
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2013-01-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
167.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
26
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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