Wellbrooke Of Wabash - Wabash Nursing Home
General Information
UPDATEFederal Provider Number
155806
Provider Name
WELLBROOKE OF WABASH
Provider Address
20 JOHN KISSINGER DRIVE
WABASH, IN 46992
WABASH, IN 46992
Provider Phone Number
(260) 274-0444
Provider SSA County
840
Provider County Name
Wabash
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
70
Number of Residents in Certified Beds
32
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LCS WABASH LLC
Date First Approved to Provide Medicare and Medicaid services
2013-03-28
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
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.34063
Reported LPN Staffing Hours per Resident per Day
0.62500
Reported RN Staffing Hours per Resident per Day
0.73594
Reported Licensed Staffing Hours per Resident per Day
1.36094
Reported Total Nurse Staffing Hours per Resident per Day
4.70157
Reported Physical Therapist Staffing Hours per Resident Per Day
0.15000
Expected CNA Staffing Hours per Resident per Day
2.28150
Expected LPN Staffing Hours per Resident per Day
0.61812
Expected RN Staffing Hours per Resident per Day
1.15257
Expected Total Nurse Staffing Hours per Resident per Day
4.05218
Adjusted CNA Staffing Hours per Resident per Day
3.59278
Adjusted LPN Staffing Hours per Resident per Day
0.83924
Adjusted RN Staffing Hours per Resident per Day
0.47710
Adjusted Total Nurse Staffing Hours per Resident per Day
4.67688
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2015-01-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2014-02-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
56
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2013-03-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
30.00000
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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