Signature Healthcare Of Bremen - Bremen Nursing Home

General Information

UPDATE
Federal Provider Number
155474
Provider Name
SIGNATURE HEALTHCARE OF BREMEN
Provider Address
316 WOODIES LN
BREMEN, IN 46506
Provider Phone Number
(574) 546-3494
Provider SSA County
490
Provider County Name
Marshall
Ownership Type
For profit - Corporation
Number of Certified Beds
97
Number of Residents in Certified Beds
73
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
JACKSON COUNTY SCHNECK MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1992-10-27
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
3
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
1.97192
Reported LPN Staffing Hours per Resident per Day
0.89932
Reported RN Staffing Hours per Resident per Day
0.55411
Reported Licensed Staffing Hours per Resident per Day
1.45342
Reported Total Nurse Staffing Hours per Resident per Day
3.42535
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02260
Expected CNA Staffing Hours per Resident per Day
2.56753
Expected LPN Staffing Hours per Resident per Day
0.63945
Expected RN Staffing Hours per Resident per Day
0.94214
Expected Total Nurse Staffing Hours per Resident per Day
4.14912
Adjusted CNA Staffing Hours per Resident per Day
1.88449
Adjusted LPN Staffing Hours per Resident per Day
1.16732
Adjusted RN Staffing Hours per Resident per Day
0.43946
Adjusted Total Nurse Staffing Hours per Resident per Day
3.32775
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-08-15
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-07-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
21
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
14
Cycle 3 Health Deficiency Score
160
Cycle 3 Standard Health Survey Date
2012-06-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
160
Total Weighted Health Survey Score
60.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
22
Number of Fines
2
Total Amount of Fines in Dollars
3900
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01

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