Presence Sacred Heart Home - Avilla Nursing Home
General Information
UPDATEFederal Provider Number
155512
Provider Name
PRESENCE SACRED HEART HOME
Provider Address
515 N MAIN ST
AVILLA, IN 46710
AVILLA, IN 46710
Provider Phone Number
(260) 897-2841
Provider SSA County
560
Provider County Name
Noble
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
133
Number of Residents in Certified Beds
115
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PRESENCE LIFE CONNECTIONS
Date First Approved to Provide Medicare and Medicaid services
1994-05-01
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
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
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.72043
Reported LPN Staffing Hours per Resident per Day
0.95652
Reported RN Staffing Hours per Resident per Day
0.80304
Reported Licensed Staffing Hours per Resident per Day
1.75957
Reported Total Nurse Staffing Hours per Resident per Day
4.47999
Reported Physical Therapist Staffing Hours per Resident Per Day
0.04957
Expected CNA Staffing Hours per Resident per Day
2.46496
Expected LPN Staffing Hours per Resident per Day
0.59244
Expected RN Staffing Hours per Resident per Day
0.97555
Expected Total Nurse Staffing Hours per Resident per Day
4.03295
Adjusted CNA Staffing Hours per Resident per Day
2.70800
Adjusted LPN Staffing Hours per Resident per Day
1.34006
Adjusted RN Staffing Hours per Resident per Day
0.61507
Adjusted Total Nurse Staffing Hours per Resident per Day
4.47771
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-03-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
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
2013-03-01
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
8
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-04-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
20.66700
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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