Indiana Nursing Homes >> Fort Wayne Nursing Homes >> Renaissance Village

Renaissance Village - Fort Wayne Nursing Home

General Information

UPDATE
Federal Provider Number
155322
Provider Name
RENAISSANCE VILLAGE
Provider Address
6050 S CR 800 E 92
FORT WAYNE, IN 46814
Provider Phone Number
2606253545
Provider SSA County
1
Provider County Name
Allen
Ownership Type
For profit - Corporation
Number of Certified Beds
96
Number of Residents in Certified Beds
58
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PHRV, LLC
Date First Approved to Provide Medicare and Medicaid services
1988-08-15
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
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
4
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
2
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
1.85086
Reported LPN Staffing Hours per Resident per Day
0.75000
Reported RN Staffing Hours per Resident per Day
0.77845
Reported Licensed Staffing Hours per Resident per Day
1.52845
Reported Total Nurse Staffing Hours per Resident per Day
3.37931
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01724
Expected CNA Staffing Hours per Resident per Day
2.61088
Expected LPN Staffing Hours per Resident per Day
0.66235
Expected RN Staffing Hours per Resident per Day
0.91430
Expected Total Nurse Staffing Hours per Resident per Day
4.18753
Adjusted CNA Staffing Hours per Resident per Day
1.73944
Adjusted LPN Staffing Hours per Resident per Day
0.93983
Adjusted RN Staffing Hours per Resident per Day
0.63618
Adjusted Total Nurse Staffing Hours per Resident per Day
3.25291
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-10-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-11-22
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
14
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2012-10-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
22.00000
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

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