Winchester House - Libertyville Nursing Home
General Information
UPDATEFederal Provider Number
145460
Provider Name
WINCHESTER HOUSE
Provider Address
1125 NORTH MILWAUKEE AVENUE
LIBERTYVILLE, IL 60048
LIBERTYVILLE, IL 60048
Provider Phone Number
(847) 377-7200
Provider SSA County
570
Provider County Name
Lake
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
360
Number of Residents in Certified Beds
167
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COUNTY OF LAKE
Date First Approved to Provide Medicare and Medicaid services
1982-10-21
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
4
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
2.86976
Reported LPN Staffing Hours per Resident per Day
0.43234
Reported RN Staffing Hours per Resident per Day
0.83952
Reported Licensed Staffing Hours per Resident per Day
1.27186
Reported Total Nurse Staffing Hours per Resident per Day
4.14162
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06856
Expected CNA Staffing Hours per Resident per Day
2.55098
Expected LPN Staffing Hours per Resident per Day
0.66860
Expected RN Staffing Hours per Resident per Day
1.05148
Expected Total Nurse Staffing Hours per Resident per Day
4.27107
Adjusted CNA Staffing Hours per Resident per Day
2.76032
Adjusted LPN Staffing Hours per Resident per Day
0.53670
Adjusted RN Staffing Hours per Resident per Day
0.59658
Adjusted Total Nurse Staffing Hours per Resident per Day
3.90873
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2014-09-25
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
8
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2013-10-31
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
60
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
14
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
108
Cycle 3 Standard Health Survey Date
2012-10-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
108
Total Weighted Health Survey Score
78.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
10
Number of Fines
2
Total Amount of Fines in Dollars
21353
Number of Payment Denials
1
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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