Hubbard Hill Estates Inc - Elkhart Nursing Home
General Information
UPDATEFederal Provider Number
155754
Provider Name
HUBBARD HILL ESTATES INC
Provider Address
28070 CR 24
ELKHART, IN 46517
ELKHART, IN 46517
Provider Phone Number
(574) 295-6260
Provider SSA County
190
Provider County Name
Elkhart
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
66
Number of Residents in Certified Beds
60
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HUBBARD HILL ESTATES, INC.
Date First Approved to Provide Medicare and Medicaid services
2006-07-27
Continuing Care Retirement Community
Y
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
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
0.34500
Reported LPN Staffing Hours per Resident per Day
0.16167
Reported RN Staffing Hours per Resident per Day
1.16667
Reported Licensed Staffing Hours per Resident per Day
1.32833
Reported Total Nurse Staffing Hours per Resident per Day
1.67334
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11333
Expected CNA Staffing Hours per Resident per Day
2.52129
Expected LPN Staffing Hours per Resident per Day
0.61480
Expected RN Staffing Hours per Resident per Day
1.03982
Expected Total Nurse Staffing Hours per Resident per Day
4.17591
Adjusted CNA Staffing Hours per Resident per Day
0.33575
Adjusted LPN Staffing Hours per Resident per Day
0.21826
Adjusted RN Staffing Hours per Resident per Day
0.83835
Adjusted Total Nurse Staffing Hours per Resident per Day
1.61523
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2015-03-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2014-02-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
56
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2013-03-06
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
39.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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