Heritage Park - Fort Wayne Nursing Home
General Information
UPDATEFederal Provider Number
155095
Provider Name
HERITAGE PARK
Provider Address
2001 HOBSON RD
FORT WAYNE, IN 46805
FORT WAYNE, IN 46805
Provider Phone Number
2604849557
Provider SSA County
10
Provider County Name
Allen
Ownership Type
Non profit - Corporation
Number of Certified Beds
180
Number of Residents in Certified Beds
163
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY
Date First Approved to Provide Medicare and Medicaid services
1969-06-24
Continuing Care Retirement Community
Y
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
5
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
3.09387
Reported LPN Staffing Hours per Resident per Day
1.22055
Reported RN Staffing Hours per Resident per Day
0.85184
Reported Licensed Staffing Hours per Resident per Day
2.07239
Reported Total Nurse Staffing Hours per Resident per Day
5.16626
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10951
Expected CNA Staffing Hours per Resident per Day
2.80983
Expected LPN Staffing Hours per Resident per Day
0.82882
Expected RN Staffing Hours per Resident per Day
1.42079
Expected Total Nurse Staffing Hours per Resident per Day
5.05943
Adjusted CNA Staffing Hours per Resident per Day
2.70174
Adjusted LPN Staffing Hours per Resident per Day
1.22229
Adjusted RN Staffing Hours per Resident per Day
0.44799
Adjusted Total Nurse Staffing Hours per Resident per Day
4.11601
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2015-01-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2014-02-24
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
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2013-02-19
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
26.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
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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