Warren Barr North Shore - Highland Park Nursing Home
General Information
UPDATEFederal Provider Number
145923
Provider Name
WARREN BARR NORTH SHORE
Provider Address
2773 SKOKIE VALLEY ROAD
HIGHLAND PARK, IL 60035
HIGHLAND PARK, IL 60035
Provider Phone Number
8472669266
Provider SSA County
570
Provider County Name
Lake
Ownership Type
For profit - Partnership
Number of Certified Beds
191
Number of Residents in Certified Beds
100
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WARREN BARR NORTH SHORE LLC
Date First Approved to Provide Medicare and Medicaid services
1997-03-10
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
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
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.52000
Reported LPN Staffing Hours per Resident per Day
0.74600
Reported RN Staffing Hours per Resident per Day
1.40000
Reported Licensed Staffing Hours per Resident per Day
2.14600
Reported Total Nurse Staffing Hours per Resident per Day
4.66600
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12550
Expected CNA Staffing Hours per Resident per Day
2.58694
Expected LPN Staffing Hours per Resident per Day
0.67346
Expected RN Staffing Hours per Resident per Day
1.19308
Expected Total Nurse Staffing Hours per Resident per Day
4.45347
Adjusted CNA Staffing Hours per Resident per Day
2.39021
Adjusted LPN Staffing Hours per Resident per Day
0.91940
Adjusted RN Staffing Hours per Resident per Day
0.87679
Adjusted Total Nurse Staffing Hours per Resident per Day
4.22326
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-10-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-12-17
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
5
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-10-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
51.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
7
Number of Fines
1
Total Amount of Fines in Dollars
20000
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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