Twin City Health Care - Gas City Nursing Home

General Information

UPDATE
Federal Provider Number
155232
Provider Name
TWIN CITY HEALTH CARE
Provider Address
627 E NORTH ST
GAS CITY, IN 46933
Provider Phone Number
(765) 674-8516
Provider SSA County
260
Provider County Name
Grant
Ownership Type
Government - County
Number of Certified Beds
75
Number of Residents in Certified Beds
54
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WITHAM MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1984-04-13
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
1
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
3.22500
Reported LPN Staffing Hours per Resident per Day
1.89722
Reported RN Staffing Hours per Resident per Day
1.14722
Reported Licensed Staffing Hours per Resident per Day
3.04444
Reported Total Nurse Staffing Hours per Resident per Day
6.26944
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08241
Expected CNA Staffing Hours per Resident per Day
2.31783
Expected LPN Staffing Hours per Resident per Day
0.72276
Expected RN Staffing Hours per Resident per Day
1.22178
Expected Total Nurse Staffing Hours per Resident per Day
4.26237
Adjusted CNA Staffing Hours per Resident per Day
3.41405
Adjusted LPN Staffing Hours per Resident per Day
2.17872
Adjusted RN Staffing Hours per Resident per Day
0.70160
Adjusted Total Nurse Staffing Hours per Resident per Day
5.92897
Cycle 1 Total Number of Health Deficiencies
16
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
6
Cycle 1 Health Deficiency Score
108
Cycle 1 Standard Survey Health Date
2014-10-27
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
108
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-12-23
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2012-10-05
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
64.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
6
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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