Swiss Village - Berne Nursing Home

General Information

UPDATE
Federal Provider Number
155707
Provider Name
SWISS VILLAGE
Provider Address
1350 W MAIN ST
BERNE, IN 46711
Provider Phone Number
(260) 589-3173
Provider SSA County
0
Provider County Name
Adams
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
128
Number of Residents in Certified Beds
116
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WOODLAWN HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
2002-09-25
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
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
3.31638
Reported LPN Staffing Hours per Resident per Day
0.67284
Reported RN Staffing Hours per Resident per Day
1.01853
Reported Licensed Staffing Hours per Resident per Day
1.69138
Reported Total Nurse Staffing Hours per Resident per Day
5.00775
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.41518
Expected LPN Staffing Hours per Resident per Day
0.58096
Expected RN Staffing Hours per Resident per Day
0.87742
Expected Total Nurse Staffing Hours per Resident per Day
3.87355
Adjusted CNA Staffing Hours per Resident per Day
3.36928
Adjusted LPN Staffing Hours per Resident per Day
0.96127
Adjusted RN Staffing Hours per Resident per Day
0.86737
Adjusted Total Nurse Staffing Hours per Resident per Day
5.21117
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-08-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2013-10-01
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-10-17
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
36.00000
Number of Facility Reported Incidents
0
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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