Glenbrook Rehabilitation & Skilled Nursing Center - Fort Wayne Nursing Home
General Information
UPDATEFederal Provider Number
155176
Provider Name
GLENBROOK REHABILITATION & SKILLED NURSING CENTER
Provider Address
3811 PARNELL AVE
FORT WAYNE, IN 46805
FORT WAYNE, IN 46805
Provider Phone Number
(260) 482-4651
Provider SSA County
10
Provider County Name
Allen
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
82
Number of Residents in Certified Beds
70
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
1976-05-24
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.90786
Reported LPN Staffing Hours per Resident per Day
1.11357
Reported RN Staffing Hours per Resident per Day
1.06357
Reported Licensed Staffing Hours per Resident per Day
2.17714
Reported Total Nurse Staffing Hours per Resident per Day
5.08500
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08071
Expected CNA Staffing Hours per Resident per Day
2.76912
Expected LPN Staffing Hours per Resident per Day
0.84180
Expected RN Staffing Hours per Resident per Day
1.55164
Expected Total Nurse Staffing Hours per Resident per Day
5.16256
Adjusted CNA Staffing Hours per Resident per Day
2.57663
Adjusted LPN Staffing Hours per Resident per Day
1.09796
Adjusted RN Staffing Hours per Resident per Day
0.51217
Adjusted Total Nurse Staffing Hours per Resident per Day
3.97034
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-10-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-12-06
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
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
2012-11-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
26.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
12
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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