Timbercrest Church Of The Brethren Home - North Manchester Nursing Home
General Information
UPDATEFederal Provider Number
155740
Provider Name
TIMBERCREST CHURCH OF THE BRETHREN HOME
Provider Address
2201 EAST ST
NORTH MANCHESTER, IN 46962
NORTH MANCHESTER, IN 46962
Provider Phone Number
(260) 982-2118
Provider SSA County
840
Provider County Name
Wabash
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
65
Number of Residents in Certified Beds
60
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
2005-09-23
Continuing Care Retirement Community
Y
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
5
Overall Rating Footnote
Health Inspection Rating
4
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
3.83833
Reported LPN Staffing Hours per Resident per Day
1.17500
Reported RN Staffing Hours per Resident per Day
0.79583
Reported Licensed Staffing Hours per Resident per Day
1.97083
Reported Total Nurse Staffing Hours per Resident per Day
5.80916
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02833
Expected CNA Staffing Hours per Resident per Day
2.37706
Expected LPN Staffing Hours per Resident per Day
0.52563
Expected RN Staffing Hours per Resident per Day
0.80214
Expected Total Nurse Staffing Hours per Resident per Day
3.70482
Adjusted CNA Staffing Hours per Resident per Day
3.96209
Adjusted LPN Staffing Hours per Resident per Day
1.85540
Adjusted RN Staffing Hours per Resident per Day
0.74133
Adjusted Total Nurse Staffing Hours per Resident per Day
6.32046
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-06-06
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-05-17
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-03-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
16.66700
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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