Healthwin - South Bend Nursing Home
General Information
UPDATEFederal Provider Number
155153
Provider Name
HEALTHWIN
Provider Address
20531 DARDEN RD
SOUTH BEND, IN 46637
SOUTH BEND, IN 46637
Provider Phone Number
(574) 272-0100
Provider SSA County
700
Provider County Name
St. Joseph
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
143
Number of Residents in Certified Beds
139
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ST. CLAIR DARDEN HEALTH SYSTEM INC
Date First Approved to Provide Medicare and Medicaid services
1973-11-23
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
5
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
2.75899
Reported LPN Staffing Hours per Resident per Day
0.99856
Reported RN Staffing Hours per Resident per Day
1.14604
Reported Licensed Staffing Hours per Resident per Day
2.14460
Reported Total Nurse Staffing Hours per Resident per Day
4.90359
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08993
Expected CNA Staffing Hours per Resident per Day
2.59643
Expected LPN Staffing Hours per Resident per Day
0.69735
Expected RN Staffing Hours per Resident per Day
1.13418
Expected Total Nurse Staffing Hours per Resident per Day
4.42796
Adjusted CNA Staffing Hours per Resident per Day
2.60732
Adjusted LPN Staffing Hours per Resident per Day
1.18851
Adjusted RN Staffing Hours per Resident per Day
0.75501
Adjusted Total Nurse Staffing Hours per Resident per Day
4.46388
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-04-28
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-03-14
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-01-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
17.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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