Canterbury Nursing And Rehabilitation Center - Fort Wayne Nursing Home
General Information
UPDATEFederal Provider Number
155656
Provider Name
CANTERBURY NURSING AND REHABILITATION CENTER
Provider Address
2827 NORTHGATE BLVD
FORT WAYNE, IN 46835
FORT WAYNE, IN 46835
Provider Phone Number
2604921400
Provider SSA County
10
Provider County Name
Allen
Ownership Type
For profit - Corporation
Number of Certified Beds
142
Number of Residents in Certified Beds
95
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
DEARBORN COUNTY HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1998-08-27
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
5
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
2.07526
Reported LPN Staffing Hours per Resident per Day
1.62684
Reported RN Staffing Hours per Resident per Day
1.43474
Reported Licensed Staffing Hours per Resident per Day
3.06158
Reported Total Nurse Staffing Hours per Resident per Day
5.13684
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08053
Expected CNA Staffing Hours per Resident per Day
2.46444
Expected LPN Staffing Hours per Resident per Day
0.66757
Expected RN Staffing Hours per Resident per Day
1.18236
Expected Total Nurse Staffing Hours per Resident per Day
4.31438
Adjusted CNA Staffing Hours per Resident per Day
2.06621
Adjusted LPN Staffing Hours per Resident per Day
2.02267
Adjusted RN Staffing Hours per Resident per Day
0.90669
Adjusted Total Nurse Staffing Hours per Resident per Day
4.79932
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
6
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2015-03-02
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
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-04-14
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2013-03-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
34.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
16
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
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