Greencroft Healthcare - Goshen Nursing Home
General Information
UPDATEFederal Provider Number
155205
Provider Name
GREENCROFT HEALTHCARE
Provider Address
1225 GREENCROFT DR
GOSHEN, IN 46527
GOSHEN, IN 46527
Provider Phone Number
(574) 537-4000
Provider SSA County
190
Provider County Name
Elkhart
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
196
Number of Residents in Certified Beds
189
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GREENCROFT GOSHEN, INC.
Date First Approved to Provide Medicare and Medicaid services
1982-06-18
Continuing Care Retirement Community
Y
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
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
1.97566
Reported LPN Staffing Hours per Resident per Day
0.33254
Reported RN Staffing Hours per Resident per Day
0.69524
Reported Licensed Staffing Hours per Resident per Day
1.02778
Reported Total Nurse Staffing Hours per Resident per Day
3.00344
Reported Physical Therapist Staffing Hours per Resident Per Day
0.13280
Expected CNA Staffing Hours per Resident per Day
2.26744
Expected LPN Staffing Hours per Resident per Day
0.59342
Expected RN Staffing Hours per Resident per Day
0.90154
Expected Total Nurse Staffing Hours per Resident per Day
3.76240
Adjusted CNA Staffing Hours per Resident per Day
2.13795
Adjusted LPN Staffing Hours per Resident per Day
0.46511
Adjusted RN Staffing Hours per Resident per Day
0.57622
Adjusted Total Nurse Staffing Hours per Resident per Day
3.21778
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
72
Cycle 1 Standard Survey Health Date
2014-11-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
72
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-11-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-10-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
52.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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