Greenleaf Health Campus - Elkhart Nursing Home
General Information
UPDATEFederal Provider Number
155783
Provider Name
GREENLEAF HEALTH CAMPUS
Provider Address
1201 E BEARDSLEY
ELKHART, IN 46514
ELKHART, IN 46514
Provider Phone Number
(574) 206-0086
Provider SSA County
190
Provider County Name
Elkhart
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
55
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TRILOGY HEALTHCARE OF ELKHART, LLC
Date First Approved to Provide Medicare and Medicaid services
2010-07-20
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.28818
Reported LPN Staffing Hours per Resident per Day
0.58273
Reported RN Staffing Hours per Resident per Day
1.35545
Reported Licensed Staffing Hours per Resident per Day
1.93818
Reported Total Nurse Staffing Hours per Resident per Day
4.22636
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10364
Expected CNA Staffing Hours per Resident per Day
2.60543
Expected LPN Staffing Hours per Resident per Day
0.62075
Expected RN Staffing Hours per Resident per Day
1.08783
Expected Total Nurse Staffing Hours per Resident per Day
4.31401
Adjusted CNA Staffing Hours per Resident per Day
2.15492
Adjusted LPN Staffing Hours per Resident per Day
0.77917
Adjusted RN Staffing Hours per Resident per Day
0.93102
Adjusted Total Nurse Staffing Hours per Resident per Day
3.94901
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-10-29
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
4
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-11-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-09-26
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
35.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
10
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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