Manor Care Health Services Summer Trace - Carmel Nursing Home

General Information

UPDATE
Federal Provider Number
155618
Provider Name
MANOR CARE HEALTH SERVICES SUMMER TRACE
Provider Address
12999 N PENNSYLVANIA ST
CARMEL, IN 46032
Provider Phone Number
(317) 848-2448
Provider SSA County
280
Provider County Name
Hamilton
Ownership Type
For profit - Corporation
Number of Certified Beds
104
Number of Residents in Certified Beds
61
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MANOR CARE-SUMMER TRACE OF CARMEL IN LLC
Date First Approved to Provide Medicare and Medicaid services
1997-01-20
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
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
2.59180
Reported LPN Staffing Hours per Resident per Day
1.02623
Reported RN Staffing Hours per Resident per Day
1.58525
Reported Licensed Staffing Hours per Resident per Day
2.61148
Reported Total Nurse Staffing Hours per Resident per Day
5.20328
Reported Physical Therapist Staffing Hours per Resident Per Day
0.53197
Expected CNA Staffing Hours per Resident per Day
2.49206
Expected LPN Staffing Hours per Resident per Day
0.68870
Expected RN Staffing Hours per Resident per Day
1.25044
Expected Total Nurse Staffing Hours per Resident per Day
4.43120
Adjusted CNA Staffing Hours per Resident per Day
2.55190
Adjusted LPN Staffing Hours per Resident per Day
1.23679
Adjusted RN Staffing Hours per Resident per Day
0.94727
Adjusted Total Nurse Staffing Hours per Resident per Day
4.73324
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-11-21
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
6
Cycle 2 Health Deficiency Score
112
Cycle 2 Standard Health Survey Date
2013-12-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
112
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
100
Cycle 3 Standard Health Survey Date
2012-10-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
100
Total Weighted Health Survey Score
80.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
19
Number of Fines
1
Total Amount of Fines in Dollars
6143
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01

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