Riverside Village - Elkhart Nursing Home
General Information
UPDATEFederal Provider Number
155695
Provider Name
RIVERSIDE VILLAGE
Provider Address
1400 W FRANKLIN ST
ELKHART, IN 46516
ELKHART, IN 46516
Provider Phone Number
(574) 522-2020
Provider SSA County
190
Provider County Name
Elkhart
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
97
Number of Residents in Certified Beds
88
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY
Date First Approved to Provide Medicare and Medicaid services
2002-02-14
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
2.33693
Reported LPN Staffing Hours per Resident per Day
1.11136
Reported RN Staffing Hours per Resident per Day
0.95170
Reported Licensed Staffing Hours per Resident per Day
2.06307
Reported Total Nurse Staffing Hours per Resident per Day
4.39999
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11364
Expected CNA Staffing Hours per Resident per Day
2.73399
Expected LPN Staffing Hours per Resident per Day
0.86056
Expected RN Staffing Hours per Resident per Day
1.46287
Expected Total Nurse Staffing Hours per Resident per Day
5.05742
Adjusted CNA Staffing Hours per Resident per Day
2.09734
Adjusted LPN Staffing Hours per Resident per Day
1.07190
Adjusted RN Staffing Hours per Resident per Day
0.48611
Adjusted Total Nurse Staffing Hours per Resident per Day
3.50691
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-04-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-03-25
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
7
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2012-02-02
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
44.66700
Number of Facility Reported Incidents
0
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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