Milton Home, The - South Bend Nursing Home

General Information

UPDATE
Federal Provider Number
155738
Provider Name
MILTON HOME, THE
Provider Address
206 E MARION ST
SOUTH BEND, IN 46601
Provider Phone Number
(574) 233-0165
Provider SSA County
700
Provider County Name
St. Joseph
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
34
Number of Residents in Certified Beds
29
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MILTON HOME NURSING HOME AND REHABILITATION
Date First Approved to Provide Medicare and Medicaid services
2005-08-03
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.97414
Reported LPN Staffing Hours per Resident per Day
1.64828
Reported RN Staffing Hours per Resident per Day
0.47759
Reported Licensed Staffing Hours per Resident per Day
2.12586
Reported Total Nurse Staffing Hours per Resident per Day
5.10001
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04138
Expected CNA Staffing Hours per Resident per Day
2.39633
Expected LPN Staffing Hours per Resident per Day
0.62953
Expected RN Staffing Hours per Resident per Day
1.08546
Expected Total Nurse Staffing Hours per Resident per Day
4.11132
Adjusted CNA Staffing Hours per Resident per Day
3.04534
Adjusted LPN Staffing Hours per Resident per Day
2.17316
Adjusted RN Staffing Hours per Resident per Day
0.32876
Adjusted Total Nurse Staffing Hours per Resident per Day
5.00025
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
15
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
96
Cycle 1 Standard Survey Health Date
2014-08-26
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
48
Cycle 1 Total Health Score
144
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-08-08
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
9
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
8
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-06-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
80.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
8
Number of Fines
1
Total Amount of Fines in Dollars
51500
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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