LAKE FOREST PLACE
1100 PEMBRIDGE DRIVE
LAKE FOREST, IL, 60045
8476046701
CCN: 145986
5
Overall4
Health5
Staffing3
QualitySpecial FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
OIG Federal Exclusion Matches (1)
This facility's name matches one or more entities on the OIG List of Excluded Individuals/Entities (LEIE). Excluded parties are prohibited from participation in Medicare and Medicaid programs.
FOREST PARK, L L C
1128a2
Excluded 2011-03-20
Ownership
| Name | Role | % |
|---|---|---|
| LAKE FOREST PLACE, LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% |
| PRESBYTERIAN HOMES | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100% |
| LINCOLN, MICHAEL | CORPORATE DIRECTOR | NOT APPLICABLE |
| HITE, ELINOR | CORPORATE DIRECTOR | NOT APPLICABLE |
| KELLY, VINCENT | CORPORATE DIRECTOR | NOT APPLICABLE |
| KIRBY, MICHAEL | CORPORATE DIRECTOR | NOT APPLICABLE |
| MARX, DENNIE | CORPORATE DIRECTOR | NOT APPLICABLE |
| MCAFEE, THOMAS | CORPORATE DIRECTOR | NOT APPLICABLE |
| MOLLMAN, ERIC | CORPORATE DIRECTOR | NOT APPLICABLE |
| NOBLE, PAULA | CORPORATE DIRECTOR | NOT APPLICABLE |
| SEYMOUR, JULIE | CORPORATE DIRECTOR | NOT APPLICABLE |
| TOLEDO, MARK | CORPORATE DIRECTOR | NOT APPLICABLE |
| WETZEL, MARK | CORPORATE DIRECTOR | NOT APPLICABLE |
| BRAULT, JAMES | CORPORATE DIRECTOR | NOT APPLICABLE |
| DENISON, CHARLES | CORPORATE DIRECTOR | NOT APPLICABLE |
| DONNERSBERGER, DAVID | CORPORATE DIRECTOR | NOT APPLICABLE |
| HEENAN, MONICA | CORPORATE DIRECTOR | NOT APPLICABLE |
| SWORTZEL, TODD | CORPORATE OFFICER | NOT APPLICABLE |
| ABI-ANTOUN, NADIM | CORPORATE OFFICER | NOT APPLICABLE |
| HAVRILKA, MARK | CORPORATE OFFICER | NOT APPLICABLE |
| PRESBYTERIAN HOMES MANAGER LLC | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| ABI-ANTOUN, NADIM | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| HAVRILKA, MARK | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| SWORTZEL, TODD | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| VANBERKEL, CAROL | W-2 MANAGING EMPLOYEE | NOT APPLICABLE |
| FAMILARA, CEAZAR | W-2 MANAGING EMPLOYEE | NOT APPLICABLE |
| GREEN, LESLIE | W-2 MANAGING EMPLOYEE | NOT APPLICABLE |
Health Deficiencies (13)
2026-01-28 · Health
D
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
2025-08-13 · Health
D
F761 · Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
2025-02-27 · Health
G
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
2024-12-12 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
F
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
F693 · Quality of Life and Care Deficiencies
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
2024-08-14 · Health
D
F584 · Resident Rights Deficiencies
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
D
F550 · Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
2024-05-08 · Health
D
F811 · Nutrition and Dietary Deficiencies
Ensure that residents are assessed for appropriateness for a feeding assistant program, receive services as per their plan of care, and feeding assistants are trained and supervised.
2024-01-11 · Health
D
F690 · Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
2023-03-08 · Health
D
F761 · Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
G
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
F661 · Resident Assessment and Care Planning Deficiencies
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day3.68
5.53
RN Hrs/Resident/Day0.54
2.27
LPN Hrs/Resident/Day0.81
0.34
CNA Hrs/Resident/Day2.33
2.92
PT Hrs/Resident/Day0.12
0.21
Data as of 2026-03-01