Lincolnshire Health & Rehabilitation Center - Merrillville Nursing Home
General Information
UPDATEFederal Provider Number
155650
Provider Name
LINCOLNSHIRE HEALTH & REHABILITATION CENTER
Provider Address
8380 VIRGINIA ST
MERRILLVILLE, IN 46410
MERRILLVILLE, IN 46410
Provider Phone Number
2197699009
Provider SSA County
440
Provider County Name
Lake
Ownership Type
For profit - Corporation
Number of Certified Beds
100
Number of Residents in Certified Beds
78
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MAJOR HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1998-04-27
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
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
1.33974
Reported LPN Staffing Hours per Resident per Day
0.33974
Reported RN Staffing Hours per Resident per Day
0.64551
Reported Licensed Staffing Hours per Resident per Day
0.98526
Reported Total Nurse Staffing Hours per Resident per Day
2.32499
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08974
Expected CNA Staffing Hours per Resident per Day
2.49867
Expected LPN Staffing Hours per Resident per Day
0.73204
Expected RN Staffing Hours per Resident per Day
1.22680
Expected Total Nurse Staffing Hours per Resident per Day
4.45751
Adjusted CNA Staffing Hours per Resident per Day
1.31563
Adjusted LPN Staffing Hours per Resident per Day
0.38520
Adjusted RN Staffing Hours per Resident per Day
0.39316
Adjusted Total Nurse Staffing Hours per Resident per Day
2.10247
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2014-10-31
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
8
Cycle 2 Health Deficiency Score
148
Cycle 2 Standard Health Survey Date
2014-01-16
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
13
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
7
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-11-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
89.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
35
Number of Fines
1
Total Amount of Fines in Dollars
33248
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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