Nursing Care At Hartsfield Village - Munster Nursing Home
General Information
UPDATEFederal Provider Number
155662
Provider Name
NURSING CARE AT HARTSFIELD VILLAGE
Provider Address
503 OTIS R BOWEN DR
MUNSTER, IN 46321
MUNSTER, IN 46321
Provider Phone Number
2199340590
Provider SSA County
440
Provider County Name
Lake
Ownership Type
Non profit - Corporation
Number of Certified Beds
112
Number of Residents in Certified Beds
110
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COMMUNITY VILLAGE INC
Date First Approved to Provide Medicare and Medicaid services
1999-03-30
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
2
QM Rating Footnote
Staffing Rating
4
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
2.47455
Reported LPN Staffing Hours per Resident per Day
1.23500
Reported RN Staffing Hours per Resident per Day
0.73818
Reported Licensed Staffing Hours per Resident per Day
1.97318
Reported Total Nurse Staffing Hours per Resident per Day
4.44773
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06227
Expected CNA Staffing Hours per Resident per Day
2.44911
Expected LPN Staffing Hours per Resident per Day
0.64603
Expected RN Staffing Hours per Resident per Day
1.10252
Expected Total Nurse Staffing Hours per Resident per Day
4.19766
Adjusted CNA Staffing Hours per Resident per Day
2.47919
Adjusted LPN Staffing Hours per Resident per Day
1.58670
Adjusted RN Staffing Hours per Resident per Day
0.50028
Adjusted Total Nurse Staffing Hours per Resident per Day
4.27103
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-06-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
18
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
8
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2013-06-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-04-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
51.33300
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
14
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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