Ambassador Healthcare - Centerville Nursing Home
General Information
UPDATEFederal Provider Number
155490
Provider Name
AMBASSADOR HEALTHCARE
Provider Address
705 E MAIN ST
CENTERVILLE, IN 47330
CENTERVILLE, IN 47330
Provider Phone Number
7658553424
Provider SSA County
880
Provider County Name
Wayne
Ownership Type
For profit - Corporation
Number of Certified Beds
137
Number of Residents in Certified Beds
113
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WITHAM MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1993-06-01
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.62965
Reported LPN Staffing Hours per Resident per Day
1.03673
Reported RN Staffing Hours per Resident per Day
0.65796
Reported Licensed Staffing Hours per Resident per Day
1.69469
Reported Total Nurse Staffing Hours per Resident per Day
4.32434
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05044
Expected CNA Staffing Hours per Resident per Day
2.55611
Expected LPN Staffing Hours per Resident per Day
0.78080
Expected RN Staffing Hours per Resident per Day
1.21689
Expected Total Nurse Staffing Hours per Resident per Day
4.55380
Adjusted CNA Staffing Hours per Resident per Day
2.52430
Adjusted LPN Staffing Hours per Resident per Day
1.10205
Adjusted RN Staffing Hours per Resident per Day
0.40400
Adjusted Total Nurse Staffing Hours per Resident per Day
3.82779
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
6
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-02-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
6
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2013-01-15
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
12
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2011-11-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
44.66700
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
15
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Golden Living Center-golden Rule
2330 Straight Line Pike |
RICHMOND IN 47374 | 5 miles away
Golden Living Center-richmond
1042 Oak Dr |
RICHMOND IN 47374 | 5.6 miles away
Rosebud Village
2050 Chester Blvd |
RICHMOND IN 47374 | 5.7 miles away
Heritage House Of Richmond
2070 Chester Blvd |
RICHMOND IN 47374 | 5.8 miles away
Forest Park Health Campus
2401 S L St |
RICHMOND IN 47374 | 6.2 miles away
Arbor Trace Health & Living Community
3701 Hodgin Rd |
RICHMOND IN 47374 | 7.1 miles away
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