Chalet Village Health And Rehabilitation Center - Berne Nursing Home
General Information
UPDATEFederal Provider Number
155473
Provider Name
CHALET VILLAGE HEALTH AND REHABILITATION CENTER
Provider Address
1065 PARKWAY ST
BERNE, IN 46711
BERNE, IN 46711
Provider Phone Number
2605892127
Provider SSA County
0
Provider County Name
Adams
Ownership Type
Government - County
Number of Certified Beds
80
Number of Residents in Certified Beds
33
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
1992-10-27
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
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
2.36515
Reported LPN Staffing Hours per Resident per Day
1.30606
Reported RN Staffing Hours per Resident per Day
1.35455
Reported Licensed Staffing Hours per Resident per Day
2.66061
Reported Total Nurse Staffing Hours per Resident per Day
5.02576
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03182
Expected CNA Staffing Hours per Resident per Day
2.29154
Expected LPN Staffing Hours per Resident per Day
0.70171
Expected RN Staffing Hours per Resident per Day
1.24522
Expected Total Nurse Staffing Hours per Resident per Day
4.23847
Adjusted CNA Staffing Hours per Resident per Day
2.53252
Adjusted LPN Staffing Hours per Resident per Day
1.54484
Adjusted RN Staffing Hours per Resident per Day
0.81280
Adjusted Total Nurse Staffing Hours per Resident per Day
4.77963
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
100
Cycle 1 Standard Survey Health Date
2014-08-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
100
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
108
Cycle 2 Standard Health Survey Date
2013-07-12
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
7
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-08-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
92.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
8
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
Swiss Village
1350 W Main St |
BERNE IN 46711 | 0.5 mile away
Adams Woodcrest
1300 Mercer Ave |
DECATUR IN 46733 | 11.6 miles away
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