Kendallville Manor - Kendallville Nursing Home
General Information
UPDATEFederal Provider Number
155482
Provider Name
KENDALLVILLE MANOR
Provider Address
1802 E DOWLING ST
KENDALLVILLE, IN 46755
KENDALLVILLE, IN 46755
Provider Phone Number
2603474374
Provider SSA County
560
Provider County Name
Noble
Ownership Type
Government - County
Number of Certified Beds
60
Number of Residents in Certified Beds
32
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ADAMS COUNTY MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1992-12-01
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
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
2.50000
Reported LPN Staffing Hours per Resident per Day
0.77500
Reported RN Staffing Hours per Resident per Day
0.88594
Reported Licensed Staffing Hours per Resident per Day
1.66094
Reported Total Nurse Staffing Hours per Resident per Day
4.16094
Reported Physical Therapist Staffing Hours per Resident Per Day
0.31406
Expected CNA Staffing Hours per Resident per Day
2.43753
Expected LPN Staffing Hours per Resident per Day
0.73385
Expected RN Staffing Hours per Resident per Day
1.50070
Expected Total Nurse Staffing Hours per Resident per Day
4.67208
Adjusted CNA Staffing Hours per Resident per Day
2.51658
Adjusted LPN Staffing Hours per Resident per Day
0.87654
Adjusted RN Staffing Hours per Resident per Day
0.44111
Adjusted Total Nurse Staffing Hours per Resident per Day
3.58991
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
8
Cycle 1 Standard Survey Health Date
2014-12-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
9
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2014-01-22
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
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
2013-02-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
30.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
8
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
Nursiong Homes Nearby
Lutheran Life Villages
351 N Allen Chapel Rd |
KENDALLVILLE IN 46755 | 0.3 mile away
Hickory Creek At Kendallville
1433 S Main St |
KENDALLVILLE IN 46755 | 1.8 miles away
Presence Sacred Heart Home
515 N Main St |
AVILLA IN 46710 | 4.9 miles away
North Ridge Village Nursing & Rehab Center
600 Trail Ridge Rd |
ALBION IN 46701 | 9.7 miles away
Avalon Village
200 Kingston Cir |
LIGONIER IN 46767 | 19.3 miles away
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