Coventry Meadows - Fort Wayne Nursing Home
General Information
UPDATEFederal Provider Number
155756
Provider Name
COVENTRY MEADOWS
Provider Address
7843 W JEFFERSON BLVD
FORT WAYNE, IN 46804
FORT WAYNE, IN 46804
Provider Phone Number
(260) 432-4848
Provider SSA County
10
Provider County Name
Allen
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
120
Number of Residents in Certified Beds
134
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
2006-06-09
Continuing Care Retirement Community
Y
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
3
Health Inspection Rating Footnote
QM Rating
5
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
2.91791
Reported LPN Staffing Hours per Resident per Day
1.34328
Reported RN Staffing Hours per Resident per Day
1.13209
Reported Licensed Staffing Hours per Resident per Day
2.47537
Reported Total Nurse Staffing Hours per Resident per Day
5.39328
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14888
Expected CNA Staffing Hours per Resident per Day
2.84382
Expected LPN Staffing Hours per Resident per Day
0.79377
Expected RN Staffing Hours per Resident per Day
1.35060
Expected Total Nurse Staffing Hours per Resident per Day
4.98819
Adjusted CNA Staffing Hours per Resident per Day
2.51762
Adjusted LPN Staffing Hours per Resident per Day
1.40460
Adjusted RN Staffing Hours per Resident per Day
0.62631
Adjusted Total Nurse Staffing Hours per Resident per Day
4.35825
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-10-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-09-16
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-10-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
35.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
16
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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