St Elizabeth Healthcare Center - Delphi Nursing Home
General Information
UPDATEFederal Provider Number
155290
Provider Name
ST ELIZABETH HEALTHCARE CENTER
Provider Address
701 ARMORY RD
DELPHI, IN 46923
DELPHI, IN 46923
Provider Phone Number
7655646380
Provider SSA County
70
Provider County Name
Carroll
Ownership Type
For profit - Corporation
Number of Certified Beds
64
Number of Residents in Certified Beds
57
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TRILOGY HEALTHCARE OF CARROLL, LLC
Date First Approved to Provide Medicare and Medicaid services
1986-11-11
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
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.23509
Reported LPN Staffing Hours per Resident per Day
1.09737
Reported RN Staffing Hours per Resident per Day
0.73509
Reported Licensed Staffing Hours per Resident per Day
1.83246
Reported Total Nurse Staffing Hours per Resident per Day
4.06755
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10000
Expected CNA Staffing Hours per Resident per Day
2.47089
Expected LPN Staffing Hours per Resident per Day
0.62667
Expected RN Staffing Hours per Resident per Day
1.04709
Expected Total Nurse Staffing Hours per Resident per Day
4.14464
Adjusted CNA Staffing Hours per Resident per Day
2.21954
Adjusted LPN Staffing Hours per Resident per Day
1.45343
Adjusted RN Staffing Hours per Resident per Day
0.52456
Adjusted Total Nurse Staffing Hours per Resident per Day
3.95593
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-06-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-09-09
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
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-07-26
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
39.33300
Number of Facility Reported Incidents
3
Number of Substantiated Complaints
0
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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