Peabody Retirement Community - North Manchester Nursing Home
General Information
UPDATEFederal Provider Number
155655
Provider Name
PEABODY RETIREMENT COMMUNITY
Provider Address
400 W SEVENTH ST
NORTH MANCHESTER, IN 46962
NORTH MANCHESTER, IN 46962
Provider Phone Number
(260) 982-8616
Provider SSA County
840
Provider County Name
Wabash
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
192
Number of Residents in Certified Beds
168
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ESTELLE PEABODY MEMORIAL HOME OF THE SYNOD OF LINCOLN TRAILS OF THE PR
Date First Approved to Provide Medicare and Medicaid services
1998-08-15
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
4
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
3.20238
Reported LPN Staffing Hours per Resident per Day
0.89911
Reported RN Staffing Hours per Resident per Day
0.61607
Reported Licensed Staffing Hours per Resident per Day
1.51518
Reported Total Nurse Staffing Hours per Resident per Day
4.71756
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04762
Expected CNA Staffing Hours per Resident per Day
2.51885
Expected LPN Staffing Hours per Resident per Day
0.59610
Expected RN Staffing Hours per Resident per Day
0.92642
Expected Total Nurse Staffing Hours per Resident per Day
4.04137
Adjusted CNA Staffing Hours per Resident per Day
3.11955
Adjusted LPN Staffing Hours per Resident per Day
1.25190
Adjusted RN Staffing Hours per Resident per Day
0.49689
Adjusted Total Nurse Staffing Hours per Resident per Day
4.70534
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-12-17
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-12-13
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2012-10-30
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
22.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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