West Bend Nursing And Rehabilitation - South Bend Nursing Home
General Information
UPDATEFederal Provider Number
155355
Provider Name
WEST BEND NURSING AND REHABILITATION
Provider Address
4600 W WASHINGTON AVE
SOUTH BEND, IN 46619
SOUTH BEND, IN 46619
Provider Phone Number
(574) 282-1294
Provider SSA County
700
Provider County Name
St. Joseph
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
157
Number of Residents in Certified Beds
94
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
1990-03-08
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
4
Health Inspection Rating Footnote
QM Rating
5
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
2.69734
Reported LPN Staffing Hours per Resident per Day
0.87021
Reported RN Staffing Hours per Resident per Day
1.04628
Reported Licensed Staffing Hours per Resident per Day
1.91649
Reported Total Nurse Staffing Hours per Resident per Day
4.61383
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08670
Expected CNA Staffing Hours per Resident per Day
2.75325
Expected LPN Staffing Hours per Resident per Day
0.79676
Expected RN Staffing Hours per Resident per Day
1.38216
Expected Total Nurse Staffing Hours per Resident per Day
4.93216
Adjusted CNA Staffing Hours per Resident per Day
2.40388
Adjusted LPN Staffing Hours per Resident per Day
0.90652
Adjusted RN Staffing Hours per Resident per Day
0.56562
Adjusted Total Nurse Staffing Hours per Resident per Day
3.77074
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-01-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-01-10
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
7
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2011-10-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
16.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
19
Number of Fines
1
Total Amount of Fines in Dollars
2275
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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