Libertyville Manor Ext Care - Libertyville Nursing Home
General Information
UPDATEFederal Provider Number
145344
Provider Name
LIBERTYVILLE MANOR EXT CARE
Provider Address
610 PETERSON ROAD
LIBERTYVILLE, IL 60048
LIBERTYVILLE, IL 60048
Provider Phone Number
8473676100
Provider SSA County
570
Provider County Name
Lake
Ownership Type
For profit - Corporation
Number of Certified Beds
63
Number of Residents in Certified Beds
22
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LIBERTYVILLE MANOR EXTENDED CARE FACILITY, INC.
Date First Approved to Provide Medicare and Medicaid services
1978-04-01
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
0
Staffing Rating Footnote
Data Not Available
RN Staffing Rating
0
RN Staffing Rating Footnote
Data Not Available
Reported Staffing Footnote
Staffing Values not Reported because of Data Quality Concerns
Physical Therapist Staffing Footnote
Physical Therapy Staffing Values not Reported because of Data Quality Concerns
Reported CNA Staffing Hours per Resident per Day
0.00000
Reported LPN Staffing Hours per Resident per Day
0.00000
Reported RN Staffing Hours per Resident per Day
0.00000
Reported Licensed Staffing Hours per Resident per Day
0.00000
Reported Total Nurse Staffing Hours per Resident per Day
0.00000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.09205
Expected LPN Staffing Hours per Resident per Day
0.73185
Expected RN Staffing Hours per Resident per Day
1.64856
Expected Total Nurse Staffing Hours per Resident per Day
4.47247
Adjusted CNA Staffing Hours per Resident per Day
0.00000
Adjusted LPN Staffing Hours per Resident per Day
0.00000
Adjusted RN Staffing Hours per Resident per Day
0.00000
Adjusted Total Nurse Staffing Hours per Resident per Day
0.00000
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-12-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-11-22
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2013-01-17
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
18.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
1
Total Number of Penalties
1
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Winchester House
1125 North Milwaukee Avenue |
LIBERTYVILLE IL 60048 | 1.2 miles away
Manorcare Of Libertyville
1500 South Milwaukee Avenue |
LIBERTYVILLE IL 60048 | 3.7 miles away
Claridge Healthcare Center
700 Jenkisson |
LAKE BLUFF IL 60044 | 5 miles away
Glenlake Terrace Nursing & Reh
2222 West 14th Street |
WAUKEGAN IL 60085 | 6.2 miles away
Lake Forest Place
1100 Pembridge Drive |
LAKE FOREST IL 60045 | 6.3 miles away
Bayside Terrace
1100 South Lewis Avenue |
WAUKEGAN IL 60085 | 6.5 miles away
Lake Forest Hospital Snu
660 North Westmoreland Road |
LAKE FOREST IL 60045 | 6.8 miles away
Lake Park Center
919 Washington Park |
WAUKEGAN IL 60085 | 6.9 miles away
Pavilion Of Waukegan
2217 Washington Street |
WAUKEGAN IL 60085 | 6.9 miles away
Warren Barr Lincolnshire
150 Jamestown Lane |
LINCOLNSHIRE IL 60069 | 7.4 miles away
Hillcrest Retirement Village
1740 North Circuit Drive |
ROUND LAKE BEACH IL 60073 | 7.6 miles away
Village At Victory Lakes, The
1055 East Grand Avenue |
LINDENHURST IL 60046 | 8.4 miles away
Terrace Nursing Home,the
1615 Sunset Avenue |
WAUKEGAN IL 60087 | 8.6 miles away
Radford Green
960 Audubon Way |
LINCOLNSHIRE IL 60069 | 9 miles away
Wauconda Healthcare And Rehab
176 Thomas Court |
WAUCONDA IL 60084 | 9.5 miles away
Reviews: Be the first to review this provider.
Share your experience with Libertyville Manor Ext Care. You can help others by writing a review.
