Signature Healthcare Of South Bend - South Bend Nursing Home
General Information
UPDATEFederal Provider Number
155219
Provider Name
SIGNATURE HEALTHCARE OF SOUTH BEND
Provider Address
52654 N IRONWOOD RD
SOUTH BEND, IN 46635
SOUTH BEND, IN 46635
Provider Phone Number
(574) 277-8710
Provider SSA County
700
Provider County Name
St. Joseph
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
92
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
1983-08-04
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
2
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
2.52717
Reported LPN Staffing Hours per Resident per Day
1.02446
Reported RN Staffing Hours per Resident per Day
0.78098
Reported Licensed Staffing Hours per Resident per Day
1.80543
Reported Total Nurse Staffing Hours per Resident per Day
4.33261
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11902
Expected CNA Staffing Hours per Resident per Day
2.49968
Expected LPN Staffing Hours per Resident per Day
0.68699
Expected RN Staffing Hours per Resident per Day
1.14329
Expected Total Nurse Staffing Hours per Resident per Day
4.32996
Adjusted CNA Staffing Hours per Resident per Day
2.48068
Adjusted LPN Staffing Hours per Resident per Day
1.23772
Adjusted RN Staffing Hours per Resident per Day
0.51041
Adjusted Total Nurse Staffing Hours per Resident per Day
4.03336
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-07-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
72
Cycle 2 Standard Health Survey Date
2013-06-22
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
72
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
84
Cycle 3 Standard Health Survey Date
2012-05-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
84
Total Weighted Health Survey Score
64.00000
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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