Grey Stone Health & Rehabilitation Center - Fort Wayne Nursing Home
General Information
UPDATEFederal Provider Number
155809
Provider Name
GREY STONE HEALTH & REHABILITATION CENTER
Provider Address
10445 DUPONT OAKS BLVD
FORT WAYNE, IN 46845
FORT WAYNE, IN 46845
Provider Phone Number
(260) 471-4770
Provider SSA County
10
Provider County Name
Allen
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
84
Number of Residents in Certified Beds
68
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MAJOR HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
2013-09-11
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
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
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
1.96250
Reported LPN Staffing Hours per Resident per Day
0.92941
Reported RN Staffing Hours per Resident per Day
0.75294
Reported Licensed Staffing Hours per Resident per Day
1.68235
Reported Total Nurse Staffing Hours per Resident per Day
3.64485
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08824
Expected CNA Staffing Hours per Resident per Day
2.37684
Expected LPN Staffing Hours per Resident per Day
0.72818
Expected RN Staffing Hours per Resident per Day
1.30086
Expected Total Nurse Staffing Hours per Resident per Day
4.40588
Adjusted CNA Staffing Hours per Resident per Day
2.02596
Adjusted LPN Staffing Hours per Resident per Day
1.05937
Adjusted RN Staffing Hours per Resident per Day
0.43248
Adjusted Total Nurse Staffing Hours per Resident per Day
3.33464
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
44
Cycle 1 Standard Survey Health Date
2014-10-07
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
44
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-09-11
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
0000-00-00
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
26.40000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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