Bethlehem Woods Nursing And Rehabilitation - Fort Wayne Nursing Home
General Information
UPDATEFederal Provider Number
155679
Provider Name
BETHLEHEM WOODS NURSING AND REHABILITATION
Provider Address
4430 ELSDALE DR
FORT WAYNE, IN 46835
FORT WAYNE, IN 46835
Provider Phone Number
(260) 485-8157
Provider SSA County
10
Provider County Name
Allen
Provider Website
Provider Description
Ownership Type
Government - State
Number of Certified Beds
90
Number of Residents in Certified Beds
84
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
2000-10-26
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
2.64702
Reported LPN Staffing Hours per Resident per Day
0.59881
Reported RN Staffing Hours per Resident per Day
1.15119
Reported Licensed Staffing Hours per Resident per Day
1.75000
Reported Total Nurse Staffing Hours per Resident per Day
4.39702
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06131
Expected CNA Staffing Hours per Resident per Day
2.88519
Expected LPN Staffing Hours per Resident per Day
0.84923
Expected RN Staffing Hours per Resident per Day
1.36770
Expected Total Nurse Staffing Hours per Resident per Day
5.10212
Adjusted CNA Staffing Hours per Resident per Day
2.25115
Adjusted LPN Staffing Hours per Resident per Day
0.58525
Adjusted RN Staffing Hours per Resident per Day
0.62892
Adjusted Total Nurse Staffing Hours per Resident per Day
3.47384
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2015-04-07
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-05-16
Cycle 2 Number of Health Revisits
0
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
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2013-04-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
2.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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