Manorcare Of Libertyville - Libertyville Nursing Home
General Information
UPDATEFederal Provider Number
145593
Provider Name
MANORCARE OF LIBERTYVILLE
Provider Address
1500 SOUTH MILWAUKEE AVENUE
LIBERTYVILLE, IL 60048
LIBERTYVILLE, IL 60048
Provider Phone Number
(847) 816-3200
Provider SSA County
570
Provider County Name
Lake
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
150
Number of Residents in Certified Beds
121
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MANOR CARE OF LIBERTYVILLE IL LLC
Date First Approved to Provide Medicare and Medicaid services
1988-06-07
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.81570
Reported LPN Staffing Hours per Resident per Day
0.36983
Reported RN Staffing Hours per Resident per Day
1.27355
Reported Licensed Staffing Hours per Resident per Day
1.64339
Reported Total Nurse Staffing Hours per Resident per Day
3.45908
Reported Physical Therapist Staffing Hours per Resident Per Day
0.36942
Expected CNA Staffing Hours per Resident per Day
2.56337
Expected LPN Staffing Hours per Resident per Day
0.81405
Expected RN Staffing Hours per Resident per Day
1.53088
Expected Total Nurse Staffing Hours per Resident per Day
4.90830
Adjusted CNA Staffing Hours per Resident per Day
1.73802
Adjusted LPN Staffing Hours per Resident per Day
0.37708
Adjusted RN Staffing Hours per Resident per Day
0.62160
Adjusted Total Nurse Staffing Hours per Resident per Day
2.84074
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-12-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-11-15
Cycle 2 Number of Health Revisits
0
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
3
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2013-01-09
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
36.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
3
Number of Fines
1
Total Amount of Fines in Dollars
7215
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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