Parkview Memorial Hospital-ccc - Fort Wayne Nursing Home
General Information
UPDATEFederal Provider Number
155516
Provider Name
PARKVIEW MEMORIAL HOSPITAL-CCC
Provider Address
2200 RANDALLIA DR
FORT WAYNE, IN 46805
FORT WAYNE, IN 46805
Provider Phone Number
(260) 373-6524
Provider SSA County
10
Provider County Name
Allen
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
41
Number of Residents in Certified Beds
33
Provider Type
Medicare
Provider Resides in Hospital
Y
Legal Business Name
PARKVIEW HOSPITAL, INC.
Date First Approved to Provide Medicare and Medicaid services
1994-04-06
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
4
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
2.84697
Reported LPN Staffing Hours per Resident per Day
1.82879
Reported RN Staffing Hours per Resident per Day
3.31364
Reported Licensed Staffing Hours per Resident per Day
5.14242
Reported Total Nurse Staffing Hours per Resident per Day
7.98940
Reported Physical Therapist Staffing Hours per Resident Per Day
0.71212
Expected CNA Staffing Hours per Resident per Day
2.34733
Expected LPN Staffing Hours per Resident per Day
0.74342
Expected RN Staffing Hours per Resident per Day
1.52300
Expected Total Nurse Staffing Hours per Resident per Day
4.61375
Adjusted CNA Staffing Hours per Resident per Day
2.97599
Adjusted LPN Staffing Hours per Resident per Day
2.04176
Adjusted RN Staffing Hours per Resident per Day
1.62571
Adjusted Total Nurse Staffing Hours per Resident per Day
6.98011
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
12
Cycle 1 Standard Survey Health Date
2015-04-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
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
2014-03-31
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
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2013-05-09
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
6.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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