South Shore Health & Rehabilitation Center - Gary Nursing Home
General Information
UPDATEFederal Provider Number
155530
Provider Name
SOUTH SHORE HEALTH & REHABILITATION CENTER
Provider Address
353 TYLER ST
GARY, IN 46402
GARY, IN 46402
Provider Phone Number
2198867070
Provider SSA County
440
Provider County Name
Lake
Ownership Type
For profit - Partnership
Number of Certified Beds
100
Number of Residents in Certified Beds
70
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
DECATUR COUNTY MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1994-07-29
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
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
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
2.90357
Reported LPN Staffing Hours per Resident per Day
0.96214
Reported RN Staffing Hours per Resident per Day
0.55571
Reported Licensed Staffing Hours per Resident per Day
1.51786
Reported Total Nurse Staffing Hours per Resident per Day
4.42142
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08143
Expected CNA Staffing Hours per Resident per Day
2.27714
Expected LPN Staffing Hours per Resident per Day
0.64188
Expected RN Staffing Hours per Resident per Day
0.95772
Expected Total Nurse Staffing Hours per Resident per Day
3.87674
Adjusted CNA Staffing Hours per Resident per Day
3.12870
Adjusted LPN Staffing Hours per Resident per Day
1.24411
Adjusted RN Staffing Hours per Resident per Day
0.43356
Adjusted Total Nurse Staffing Hours per Resident per Day
4.59724
Cycle 1 Total Number of Health Deficiencies
25
Cycle 1 Number of Standard Health Deficiencies
20
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
144
Cycle 1 Standard Survey Health Date
2014-08-22
Cycle 1 Number of Health Revisits
2
Cycle 1 Health Revisit Score
72
Cycle 1 Total Health Score
216
Cycle 2 Total Number of Health Deficiencies
27
Cycle 2 Number of Standard Health Deficiencies
21
Cycle 2 Number of Complaint Health Deficiencies
8
Cycle 2 Health Deficiency Score
180
Cycle 2 Standard Health Survey Date
2013-06-17
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
27
Cycle 3 Number of Standard Health Deficiencies
18
Cycle 3 Number of Complaint Health Deficiencies
9
Cycle 3 Health Deficiency Score
474
Cycle 3 Standard Health Survey Date
2012-04-27
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
237
Cycle 3 Total Health Score
711
Total Weighted Health Survey Score
286.50000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
33
Number of Fines
1
Total Amount of Fines in Dollars
32403
Number of Payment Denials
1
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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