Lindenhurst, IL

Village At Victory Lakes, The

5-star overall rating with 4-star inspections with $35,902 in total fines with 6 recent health deficiencies with 9 fire-safety deficiencies in the latest cycle

1055 East Grand Avenue, Lindenhurst, IL

(847) 356-5900

Compare this facility

Overall

5 / 5

CMS overall stars

Health inspections

4 / 5

Survey and complaint cycles

Staffing

4 / 5

RN + nurse staffing

Quality measures

5 / 5

Resident outcomes and process measures

Quick facts

Facility snapshot

Beds

120

Certified beds

Average residents

84

Average occupied residents

Ownership

Non-Profit

Publicly displayed owner type

Chain

Franciscan Communities

Operator or chain grouping

Approved since

1989-02-02

CMS approved date

Coverage

Medicare + Medicaid

Participation flags

Chain footprint

6 facilities

Chain averages 4 overall / 4 health / 4 staffing / 4 quality stars

Changed ownership

No

Within the last 12 months

Family council

No

Resident and family council reported

Sprinklers

Yes

Automatic sprinklers in all required areas

Staffing

Hours and turnover

RN hours / resident day

1.31

Registered nurse staffing · state 0.73 · national 0.68

LPN hours / resident day

0.71

Licensed practical nurse staffing · state 0.64 · national 0.87

Aide hours / resident day

2.24

Nurse aide staffing · state 2.13 · national 2.35

Total nurse hours

4.25

All reported nurse hours · state 3.49 · national 3.89

Licensed hours

2.01

RN + LPN hours · state 1.36 · national 1.54

Weekend hours

3.74

Weekend nurse staffing · state 3.09 · national 3.43

Weekend RN hours

0.92

Weekend registered nurse coverage · state 0.56 · national 0.47

Physical therapist

0.12

Reported PT staffing · state 0.05 · national 0.07

Adjusted RN hours

1.26

CMS adjusted RN staffing hours

Adjusted total hours

4.10

CMS adjusted total nurse staffing hours

Case-mix index

1.42

Higher values indicate more complex resident acuity

RN turnover

42%

Annual RN turnover · state 44% · national 45%

Total nurse turnover

37%

Annual nurse turnover · state 46% · national 46%

SNF VBP

Value-based purchasing

Program rank

6,094

Lower is better among SNFs in the FY 2026 VBP program.

Performance score

34.02

Composite VBP score used to determine payment impact.

Payment multiplier

0.9881

Above 1.000 increases Medicare payment; below 1.000 reduces it.

Program components

How the VBP score is built

Readmission

0

Baseline 18.43% · Performance 21.58% · Measure score 0 · Achievement 0 · Improvement 0

Healthcare-associated infections

3.67

Baseline 4.29% · Performance 6.74% · Measure score 3.67 · Achievement 3.67 · Improvement 0

Total nurse turnover

7.07

Baseline 56.57% · Performance 34.78% · Measure score 7.07 · Achievement 7.07 · Improvement 6.37

Adjusted total nurse staffing

2.87

Baseline 3.88 hours · Performance 3.89 hours · Measure score 2.87 · Achievement 2.87 · Improvement 0

SNF QRP

Medicare quality reporting measures

Measure Facility National Note
Potentially preventable 30-day readmission 11.73%
10.72%
1 pts worse
No Different than the National Rate · Eligible stays 730 · Observed rate 11.51% · Lower 95% interval 9.96%
Discharge to community 62.37%
50.57%
11.8 pts better
Better than the National Rate · Eligible stays 704 · Observed rate 58.66% · Lower 95% interval 58.48%
Medicare spending per beneficiary 0.83
1.02
0.2 pts better
Drug regimen review with follow-up 99.08%
95.27%
3.8 pts better
Numerator 433 · Denominator 437
Falls with major injury 0.69%
0.77%
0.1 pts better
Numerator 3 · Denominator 437
Discharge self-care score 54.33%
53.69%
0.6 pts better
Numerator 182 · Denominator 335
Discharge mobility score 42.69%
50.94%
8.2 pts worse
Numerator 143 · Denominator 335
Pressure ulcers or injuries, new or worsened 4.12%
2.29%
1.8 pts worse
Numerator 18 · Denominator 437 · Adjusted rate 4.14%
Healthcare-associated infections requiring hospitalization 6.74%
7.12%
0.4 pts better
No Different than the National Rate · Eligible stays 423 · Observed rate 6.38% · Lower 95% interval 4.58%
Staff COVID-19 vaccination coverage 22.03%
8.2%
13.8 pts better
Numerator 76 · Denominator 345
Staff flu vaccination coverage 14.81%
42%
27.2 pts worse
Numerator 44 · Denominator 297
Discharge function score 44.48%
56.45%
12 pts worse
Numerator 149 · Denominator 335
Transfer of health information to provider 97.89%
95.95%
1.9 pts better
Numerator 93 · Denominator 95
Transfer of health information to patient 99.32%
96.28%
3 pts better
Numerator 290 · Denominator 292
Resident COVID-19 vaccinations up to date 6.34%
25.2%
18.9 pts worse
Numerator 13 · Denominator 205

Quality measures

Resident outcomes and process scores

Measure Facility State National Note
Number of hospitalizations per 1000 long-stay resident days 0.8
2.0
1.2 pts better
1.9
1.1 pts better
Long Stay · 20240701-20250630 · Adjusted 0.8 · Observed 0.7 · Expected 1.8 · Used in QM five-star
Number of outpatient emergency department visits per 1000 long-stay resident days 0
2.3
2.3 pts better
1.8
1.8 pts better
Long Stay · 20240701-20250630 · Adjusted 0 · Observed 0 · Expected 1.4 · Used in QM five-star
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine 97.3%
89.6%
7.7 pts better
93.4%
3.9 pts better
Long Stay · 2024Q4-2025Q3 · Q1 93.6% · Q2 97.8% · Q3 97.9% · Q4 100.0% · 4Q avg 97.3%
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine 98.0%
91.6%
6.4 pts better
95.5%
2.5 pts better
Long Stay · 2024Q3-2025Q2 · 4Q avg 98.0%
Percentage of long-stay residents experiencing one or more falls with major injury 0.5%
3.3%
2.8 pts better
3.3%
2.8 pts better
Long Stay · 2024Q4-2025Q3 · Q1 2.1% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.5% · Used in QM five-star
Percentage of long-stay residents who have depressive symptoms 3.8%
50.3%
46.5 pts better
11.4%
7.6 pts better
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 4.3% · Q3 0.0% · Q4 11.6% · 4Q avg 3.8%
Percentage of long-stay residents who lose too much weight 2.8%
6.5%
3.7 pts better
5.4%
2.6 pts better
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 5.6% · Q4 6.1% · 4Q avg 2.8%
Percentage of long-stay residents who received an antianxiety or hypnotic medication 8.7%
18.5%
9.8 pts better
19.6%
10.9 pts better
Long Stay · 2024Q4-2025Q3 · Q1 7.7% · Q2 10.8% · Q3 7.9% · Q4 8.6% · 4Q avg 8.7%
Percentage of long-stay residents who received an antipsychotic medication 4.7%
22.8%
18.1 pts better
16.7%
12 pts better
Long Stay · 2024Q4-2025Q3 · Q1 5.6% · Q2 5.9% · Q3 6.2% · Q4 0.0% · 4Q avg 4.7% · Used in QM five-star
Percentage of long-stay residents who were physically restrained 0.0%
0.1%
0.1 pts better
0.1%
0.1 pts better
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0%
Percentage of long-stay residents whose need for help with daily activities has increased 4.1%
15.0%
10.9 pts better
14.9%
10.8 pts better
Long Stay · 2024Q4-2025Q3 · Q1 7.9% · Q2 2.8% · Q3 5.3% · Q4 0.0% · 4Q avg 4.1% · Used in QM five-star
Percentage of long-stay residents with a catheter inserted and left in their bladder 0.0%
1.1%
1.1 pts better
1.0%
1 pts better
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star
Percentage of long-stay residents with a urinary tract infection 0.6%
1.7%
1.1 pts better
1.7%
1.1 pts better
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 2.3% · 4Q avg 0.6% · Used in QM five-star
Percentage of long-stay residents with new or worsened bowel or bladder incontinence 22.5%
21.3%
1.2 pts worse
19.8%
2.7 pts worse
Long Stay · 2024Q4-2025Q3 · Q1 14.7% · Q2 34.8% · Q3 19.8% · Q4 21.3% · 4Q avg 22.5%
Percentage of long-stay residents with pressure ulcers 4.1%
5.2%
1.1 pts better
5.1%
1 pts better
Long Stay · 2024Q4-2025Q3 · Q1 8.3% · Q2 3.5% · Q3 3.0% · Q4 1.5% · 4Q avg 4.1% · Used in QM five-star
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine 92.3%
68.8%
23.5 pts better
81.7%
10.6 pts better
Short Stay · 2024Q4-2025Q3 · Q1 82.0% · Q2 90.3% · Q3 98.4% · Q4 99.0% · 4Q avg 92.3%
Percentage of short-stay residents who had an outpatient emergency department visit 13.4%
14.0%
0.6 pts better
12.0%
1.4 pts worse
Short Stay · 20240701-20250630 · Adjusted 13.4% · Observed 11.7% · Expected 9.7% · Used in QM five-star
Percentage of short-stay residents who newly received an antipsychotic medication 0.6%
2.3%
1.7 pts better
1.6%
1 pts better
Short Stay · 2024Q4-2025Q3 · Q1 0.3% · Q2 0.8% · Q3 0.4% · Q4 0.8% · 4Q avg 0.6% · Used in QM five-star
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine 80.3%
63.0%
17.3 pts better
79.7%
0.6 pts better
Short Stay · 2024Q3-2025Q2 · 4Q avg 80.3%
Percentage of short-stay residents who were rehospitalized after a nursing home admission 20.5%
26.2%
5.7 pts better
23.9%
3.4 pts better
Short Stay · 20240701-20250630 · Adjusted 20.5% · Observed 19.0% · Expected 22.1% · Used in QM five-star

Survey summary

Recent inspection cycles

Cycle 1 Health 2025-01-29 · Fire 2025-01-29

6 health deficiencies

Top issue: Quality of Life and Care (2 deficiencies)

9 fire-safety deficiencies

Top issue: Smoke (4 deficiencies)

Cycle 2 Health 2024-02-07 · Fire 2024-02-07

11 health deficiencies

Top issue: Quality of Life and Care (5 deficiencies)

9 fire-safety deficiencies

Top issue: Smoke (3 deficiencies)

Cycle 3 Health 2023-04-05 · Fire 2023-04-05

9 health deficiencies

Top issue: Quality of Life and Care (7 deficiencies)

11 fire-safety deficiencies

Top issue: Emergency Preparedness (4 deficiencies)

Fire safety

Fire-safety citations

F · Potential for more than minimal harm 2025-01-29

E26 · Emergency Preparedness Deficiencies

Fire Safety

Establish roles under a Waiver declared by secretary.

Corrected 2025-02-14

F · Potential for more than minimal harm 2025-01-29

K271 · Egress Deficiencies

Fire Safety

Have exits that are accessible at all times.

Corrected 2025-02-14

F · Potential for more than minimal harm 2025-01-29

K345 · Smoke Deficiencies

Fire Safety

Have approved installation, maintenance and testing program for fire alarm systems.

Corrected 2025-02-27

F · Potential for more than minimal harm 2025-01-29

K351 · Smoke Deficiencies

Fire Safety

Install an approved automatic sprinkler system.

Corrected 2025-03-17

F · Potential for more than minimal harm 2025-01-29

K712 · Miscellaneous Deficiencies

Fire Safety

Have simulated fire drills held at unexpected times.

Corrected 2025-02-14

E · Potential for more than minimal harm 2025-01-29

K222 · Egress Deficiencies

Fire Safety

Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.

Corrected 2025-03-17

E · Potential for more than minimal harm 2025-01-29

K223 · Egress Deficiencies

Fire Safety

Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.

Corrected 2025-02-14

E · Potential for more than minimal harm 2025-01-29

K363 · Smoke Deficiencies

Fire Safety

Install corridor and hallway doors that block smoke.

Corrected 2025-02-14

D · Potential for more than minimal harm 2025-01-29

K321 · Smoke Deficiencies

Fire Safety

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

Corrected 2025-02-14

F · Potential for more than minimal harm 2024-02-07

E26 · Emergency Preparedness Deficiencies

Fire Safety

Establish roles under a Waiver declared by secretary.

Corrected 2024-03-11

F · Potential for more than minimal harm 2024-02-07

K133 · Construction Deficiencies

Fire Safety

Install a two-hour-resistant firewall separation.

Corrected 2024-03-07

F · Potential for more than minimal harm 2024-02-07

K353 · Smoke Deficiencies

Fire Safety

Inspect, test, and maintain automatic sprinkler systems.

Corrected 2024-04-09

F · Potential for more than minimal harm 2024-02-07

K372 · Smoke Deficiencies

Fire Safety

Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

Corrected 2024-02-26

F · Potential for more than minimal harm 2024-02-07

K511 · Services Deficiencies

Fire Safety

Have properly installed electrical wiring and gas equipment.

Corrected 2024-03-11

F · Potential for more than minimal harm 2024-02-07

K916 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Have a battery powered remote alarm panel in a location accessible by operating personnel.

Corrected 2024-03-07

E · Potential for more than minimal harm 2024-02-07

K293 · Egress Deficiencies

Fire Safety

Have properly located and lighted "Exit" signs.

Corrected 2024-03-05

E · Potential for more than minimal harm 2024-02-07

K363 · Smoke Deficiencies

Fire Safety

Install corridor and hallway doors that block smoke.

Corrected 2024-02-22

E · Potential for more than minimal harm 2024-02-07

K920 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Ensure proper usage of power strips and extension cords.

Corrected 2024-02-23

F · Potential for more than minimal harm 2023-04-05

E18 · Emergency Preparedness Deficiencies

Fire Safety

Establish procedures for tracking staff and patients during an emergency.

Corrected 2023-05-12

F · Potential for more than minimal harm 2023-04-05

E23 · Emergency Preparedness Deficiencies

Fire Safety

Establish policies and procedures for medical documentation.

Corrected 2023-05-12

F · Potential for more than minimal harm 2023-04-05

E41 · Emergency Preparedness Deficiencies

Fire Safety

Implement emergency and standby power systems.

Corrected 2023-05-12

F · Potential for more than minimal harm 2023-04-05

E6 · Emergency Preparedness Deficiencies

Fire Safety

Conduct risk assessment and an All-Hazards approach.

Corrected 2023-05-12

F · Potential for more than minimal harm 2023-04-05

K324 · Smoke Deficiencies

Fire Safety

Provide properly protected cooking facilities.

Corrected 2023-05-12

F · Potential for more than minimal harm 2023-04-05

K346 · Smoke Deficiencies

Fire Safety

Follow proper procedures when the fire alarm was out of service for more than 4 hours.

Corrected 2023-05-12

F · Potential for more than minimal harm 2023-04-05

K354 · Smoke Deficiencies

Fire Safety

Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.

Corrected 2023-05-12

F · Potential for more than minimal harm 2023-04-05

K712 · Miscellaneous Deficiencies

Fire Safety

Have simulated fire drills held at unexpected times.

Corrected 2023-05-12

F · Potential for more than minimal harm 2023-04-05

K914 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.

Corrected 2023-05-12

F · Potential for more than minimal harm 2023-04-05

K920 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Ensure proper usage of power strips and extension cords.

Corrected 2023-05-12

E · Potential for more than minimal harm 2023-04-05

K355 · Smoke Deficiencies

Fire Safety

Properly select, install, inspect, or maintain portable fire extinguishes.

Corrected 2023-05-12

Inspection history

Recent health citations

D · Potential for more than minimal harm 2025-10-30

F809 · Nutrition and Dietary Deficiencies

Health

Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.

Corrected 2025-11-25

D · Potential for more than minimal harm 2025-10-28

F689 · Quality of Life and Care Deficiencies

Health

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Corrected 2025-11-25

G · Actual harm 2025-01-29

F686 · Quality of Life and Care Deficiencies

Health

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

Corrected 2025-02-12

E · Potential for more than minimal harm 2025-01-29

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2025-02-12

D · Potential for more than minimal harm 2025-01-29

F625 · Resident Rights Deficiencies

Health

Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.

Corrected 2025-02-12

D · Potential for more than minimal harm 2025-01-29

F644 · Resident Assessment and Care Planning Deficiencies

Health

Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

Corrected 2025-02-12

G · Actual harm 2024-02-07

F689 · Quality of Life and Care Deficiencies

Health

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Corrected 2024-03-03

E · Potential for more than minimal harm 2024-02-07

F686 · Quality of Life and Care Deficiencies

Health

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

Corrected 2024-03-03

E · Potential for more than minimal harm 2024-02-07

F803 · Nutrition and Dietary Deficiencies

Health

Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.

Corrected 2024-03-03

E · Potential for more than minimal harm 2024-02-07

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2024-03-03

D · Potential for more than minimal harm 2024-02-07

F558 · Resident Rights Deficiencies

Health

Reasonably accommodate the needs and preferences of each resident.

Corrected 2024-03-03

D · Potential for more than minimal harm 2024-02-07

F559 · Resident Rights Deficiencies

Health

Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made.

Corrected 2024-03-03

D · Potential for more than minimal harm 2024-02-07

F688 · Quality of Life and Care Deficiencies

Health

Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.

Corrected 2024-03-03

D · Potential for more than minimal harm 2024-02-07

F692 · Quality of Life and Care Deficiencies

Health

Provide enough food/fluids to maintain a resident's health.

Corrected 2024-03-03

D · Potential for more than minimal harm 2024-02-07

F759 · Pharmacy Service Deficiencies

Health

Ensure medication error rates are not 5 percent or greater.

Corrected 2024-03-03

D · Potential for more than minimal harm 2024-02-07

F760 · Pharmacy Service Deficiencies

Health

Ensure that residents are free from significant medication errors.

Corrected 2024-03-03

D · Potential for more than minimal harm 2024-02-07

F825 · Quality of Life and Care Deficiencies

Health

Provide or get specialized rehabilitative services as required for a resident.

Corrected 2024-03-03

G · Actual harm 2024-01-03

F686 · Quality of Life and Care Deficiencies

Health

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

Corrected 2024-01-19

E · Potential for more than minimal harm 2023-04-05

F677 · Quality of Life and Care Deficiencies

Health

Provide care and assistance to perform activities of daily living for any resident who is unable.

Corrected 2023-04-21

E · Potential for more than minimal harm 2023-04-05

F688 · Quality of Life and Care Deficiencies

Health

Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.

Corrected 2023-04-21

E · Potential for more than minimal harm 2023-04-05

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2023-04-21

D · Potential for more than minimal harm 2023-04-05

F684 · Quality of Life and Care Deficiencies

Health

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Corrected 2023-04-21

D · Potential for more than minimal harm 2023-04-05

F686 · Quality of Life and Care Deficiencies

Health

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

Corrected 2023-04-21

D · Potential for more than minimal harm 2023-04-05

F689 · Quality of Life and Care Deficiencies

Health

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Corrected 2023-04-21

D · Potential for more than minimal harm 2023-04-05

F690 · Quality of Life and Care Deficiencies

Health

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

Corrected 2023-04-21

D · Potential for more than minimal harm 2023-04-05

F755 · Pharmacy Service Deficiencies

Health

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

Corrected 2023-04-21

Penalties and ownership

What sits behind the stars

$19,949 2025-01-29

Fine

Fine · fine $19,949

Fine

$15,953 2024-02-07

Fine

Fine · fine $15,953

Fine

Ownership

Franciscan Sisters Of Chicago Services Corporation

5% Or Greater Direct Ownership Interest · Organization

100% 4 facilities 1988-04-22
Carroll, Elizabeth

Operational/Managerial Control · Individual

0% 2 facilities 2022-04-01
Parkhill, Roberta

Corporate Director · Individual

0% 3 facilities 2016-08-05
Parkhill, Roberta

Corporate Officer · Individual

0% 3 facilities 2021-05-18
Pomeranets, Eugene

Operational/Managerial Control · Individual

0% 1 facilities 2021-01-01
Raina, Anshu

Operational/Managerial Control · Individual

0% 1 facilities 2023-10-02
Ramirez-Justin, Andrea

Corporate Officer · Individual

0% 3 facilities 2020-08-23
Rosenberger, Robert

Corporate Officer · Individual

0% 4 facilities 2023-04-11
Stark, James

Corporate Director · Individual

0% 6 facilities 2014-02-19
Stark, James

Corporate Officer · Individual

0% 6 facilities 2021-05-18
Umanskiy, Regina

Corporate Director · Individual

0% 4 facilities 2022-07-05
Umanskiy, Regina

Corporate Officer · Individual

0% 4 facilities 2022-07-05

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