Indiana Nursing Homes >> Fort Wayne Nursing Homes >> Lutheran Life Villages

Lutheran Life Villages - Fort Wayne Nursing Home

General Information

UPDATE
Federal Provider Number
155586
Provider Name
LUTHERAN LIFE VILLAGES
Provider Address
6701 S ANTHONY BLVD
FORT WAYNE, IN 46816
Provider Phone Number
(260) 447-1591
Provider SSA County
10
Provider County Name
Allen
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
213
Number of Residents in Certified Beds
115
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
1996-02-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.84957
Reported LPN Staffing Hours per Resident per Day
1.43957
Reported RN Staffing Hours per Resident per Day
0.83696
Reported Licensed Staffing Hours per Resident per Day
2.27652
Reported Total Nurse Staffing Hours per Resident per Day
5.12610
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07957
Expected CNA Staffing Hours per Resident per Day
2.50543
Expected LPN Staffing Hours per Resident per Day
0.67240
Expected RN Staffing Hours per Resident per Day
1.12833
Expected Total Nurse Staffing Hours per Resident per Day
4.30616
Adjusted CNA Staffing Hours per Resident per Day
2.79073
Adjusted LPN Staffing Hours per Resident per Day
1.77699
Adjusted RN Staffing Hours per Resident per Day
0.55425
Adjusted Total Nurse Staffing Hours per Resident per Day
4.79843
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
28
Cycle 1 Standard Survey Health Date
2015-02-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
17
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
9
Cycle 2 Health Deficiency Score
92
Cycle 2 Standard Health Survey Date
2014-01-17
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
92
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2013-01-29
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
49.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
17
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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