Indiana Nursing Homes >> Fort Wayne Nursing Homes >> Kingston Care Center Of Fort Wayne

Kingston Care Center Of Fort Wayne - Fort Wayne Nursing Home

General Information

UPDATE
Federal Provider Number
155479
Provider Name
KINGSTON CARE CENTER OF FORT WAYNE
Provider Address
1010 W WASHINGTON CENTER RD
FORT WAYNE, IN 46825
Provider Phone Number
2604892552
Provider SSA County
10
Provider County Name
Allen
Ownership Type
For profit - Corporation
Number of Certified Beds
137
Number of Residents in Certified Beds
124
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
KINGSTON CARE CENTER OF FORT WAYNE, LLC
Date First Approved to Provide Medicare and Medicaid services
1993-01-01
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
1
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.41008
Reported LPN Staffing Hours per Resident per Day
0.98427
Reported RN Staffing Hours per Resident per Day
0.88871
Reported Licensed Staffing Hours per Resident per Day
1.87298
Reported Total Nurse Staffing Hours per Resident per Day
4.28306
Reported Physical Therapist Staffing Hours per Resident Per Day
0.15968
Expected CNA Staffing Hours per Resident per Day
2.60273
Expected LPN Staffing Hours per Resident per Day
0.70658
Expected RN Staffing Hours per Resident per Day
1.12936
Expected Total Nurse Staffing Hours per Resident per Day
4.43868
Adjusted CNA Staffing Hours per Resident per Day
2.27208
Adjusted LPN Staffing Hours per Resident per Day
1.15619
Adjusted RN Staffing Hours per Resident per Day
0.58798
Adjusted Total Nurse Staffing Hours per Resident per Day
3.88958
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2014-11-21
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
80
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-12-12
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
3
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-12-18
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
44.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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