Sanctuary At St Pauls - South Bend Nursing Home
General Information
UPDATEFederal Provider Number
155197
Provider Name
SANCTUARY AT ST PAULS
Provider Address
3602 S IRONWOOD DR
SOUTH BEND, IN 46614
SOUTH BEND, IN 46614
Provider Phone Number
(574) 299-2250
Provider SSA County
700
Provider County Name
St. Joseph
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
78
Number of Residents in Certified Beds
75
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TRINITY CONTINUING CARE SERVICES INDIANA INC
Date First Approved to Provide Medicare and Medicaid services
1981-04-27
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
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
2.91200
Reported LPN Staffing Hours per Resident per Day
1.29133
Reported RN Staffing Hours per Resident per Day
1.26200
Reported Licensed Staffing Hours per Resident per Day
2.55333
Reported Total Nurse Staffing Hours per Resident per Day
5.46533
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14267
Expected CNA Staffing Hours per Resident per Day
2.46768
Expected LPN Staffing Hours per Resident per Day
0.61654
Expected RN Staffing Hours per Resident per Day
1.07453
Expected Total Nurse Staffing Hours per Resident per Day
4.15875
Adjusted CNA Staffing Hours per Resident per Day
2.89551
Adjusted LPN Staffing Hours per Resident per Day
1.73843
Adjusted RN Staffing Hours per Resident per Day
0.87756
Adjusted Total Nurse Staffing Hours per Resident per Day
5.29732
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2015-01-21
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
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
0
Cycle 2 Standard Health Survey Date
2013-12-10
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-11-20
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
3.33300
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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