Vernon Manor Childrens Home - Wabash Nursing Home
General Information
UPDATEFederal Provider Number
155810
Provider Name
VERNON MANOR CHILDRENS HOME
Provider Address
1955 S VERNON ST
WABASH, IN 46992
WABASH, IN 46992
Provider Phone Number
(260) 563-8438
Provider SSA County
840
Provider County Name
Wabash
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
119
Number of Residents in Certified Beds
86
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
VERNON MANOR CHILDREN'S HOME, LLC
Date First Approved to Provide Medicare and Medicaid services
2013-10-12
Continuing Care Retirement Community
N
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
2
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
0.00000
Reported LPN Staffing Hours per Resident per Day
2.06395
Reported RN Staffing Hours per Resident per Day
1.50058
Reported Licensed Staffing Hours per Resident per Day
3.56453
Reported Total Nurse Staffing Hours per Resident per Day
3.56453
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01686
Expected CNA Staffing Hours per Resident per Day
2.73934
Expected LPN Staffing Hours per Resident per Day
0.92668
Expected RN Staffing Hours per Resident per Day
1.30392
Expected Total Nurse Staffing Hours per Resident per Day
4.96994
Adjusted CNA Staffing Hours per Resident per Day
0.00000
Adjusted LPN Staffing Hours per Resident per Day
1.84863
Adjusted RN Staffing Hours per Resident per Day
0.85989
Adjusted Total Nurse Staffing Hours per Resident per Day
2.89104
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2014-05-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
72
Cycle 2 Standard Health Survey Date
2013-08-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
72
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
0000-00-00
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
69.60000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
8
Number of Fines
1
Total Amount of Fines in Dollars
5460
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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