Courtyard Healthcare Center - Goshen Nursing Home
General Information
UPDATEFederal Provider Number
155689
Provider Name
COURTYARD HEALTHCARE CENTER
Provider Address
2400 COLLEGE AVE
GOSHEN, IN 46526
GOSHEN, IN 46526
Provider Phone Number
(574) 533-0351
Provider SSA County
190
Provider County Name
Elkhart
Provider Website
Provider Description
Ownership Type
Government - City/county
Number of Certified Beds
186
Number of Residents in Certified Beds
158
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ADAMS COUNTY MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
2001-03-03
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
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.39715
Reported LPN Staffing Hours per Resident per Day
1.03038
Reported RN Staffing Hours per Resident per Day
0.52310
Reported Licensed Staffing Hours per Resident per Day
1.55348
Reported Total Nurse Staffing Hours per Resident per Day
3.95063
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07247
Expected CNA Staffing Hours per Resident per Day
2.57526
Expected LPN Staffing Hours per Resident per Day
0.70052
Expected RN Staffing Hours per Resident per Day
1.11923
Expected Total Nurse Staffing Hours per Resident per Day
4.39500
Adjusted CNA Staffing Hours per Resident per Day
2.28400
Adjusted LPN Staffing Hours per Resident per Day
1.22084
Adjusted RN Staffing Hours per Resident per Day
0.34922
Adjusted Total Nurse Staffing Hours per Resident per Day
3.62334
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-06-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
14
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
40
Cycle 2 Standard Health Survey Date
2013-05-17
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
40
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
88
Cycle 3 Standard Health Survey Date
2012-04-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
88
Total Weighted Health Survey Score
46.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
20
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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