Cardinal Nursing And Rehabilitation Center - South Bend Nursing Home
General Information
UPDATEFederal Provider Number
155115
Provider Name
CARDINAL NURSING AND REHABILITATION CENTER
Provider Address
1121 E LASALLE AVE
SOUTH BEND, IN 46617
SOUTH BEND, IN 46617
Provider Phone Number
5742876501
Provider SSA County
700
Provider County Name
St. Joseph
Ownership Type
Government - County
Number of Certified Beds
144
Number of Residents in Certified Beds
108
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
1970-05-12
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
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
2.40093
Reported LPN Staffing Hours per Resident per Day
1.00000
Reported RN Staffing Hours per Resident per Day
1.13796
Reported Licensed Staffing Hours per Resident per Day
2.13796
Reported Total Nurse Staffing Hours per Resident per Day
4.53889
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09306
Expected CNA Staffing Hours per Resident per Day
2.68217
Expected LPN Staffing Hours per Resident per Day
0.80571
Expected RN Staffing Hours per Resident per Day
1.38388
Expected Total Nurse Staffing Hours per Resident per Day
4.87176
Adjusted CNA Staffing Hours per Resident per Day
2.19642
Adjusted LPN Staffing Hours per Resident per Day
1.03015
Adjusted RN Staffing Hours per Resident per Day
0.61442
Adjusted Total Nurse Staffing Hours per Resident per Day
3.75548
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-12-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-10-30
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
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2013-04-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
16.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
14
Number of Fines
1
Total Amount of Fines in Dollars
3679
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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