Wintersong Village - Knox Nursing Home
General Information
UPDATEFederal Provider Number
155283
Provider Name
WINTERSONG VILLAGE
Provider Address
1005 S EDGEWOOD DR
KNOX, IN 46534
KNOX, IN 46534
Provider Phone Number
(574) 772-5826
Provider SSA County
740
Provider County Name
Starke
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
48
Number of Residents in Certified Beds
34
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
1986-06-10
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
1
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
2.20147
Reported LPN Staffing Hours per Resident per Day
1.23971
Reported RN Staffing Hours per Resident per Day
1.92353
Reported Licensed Staffing Hours per Resident per Day
3.16324
Reported Total Nurse Staffing Hours per Resident per Day
5.36471
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11324
Expected CNA Staffing Hours per Resident per Day
2.52797
Expected LPN Staffing Hours per Resident per Day
0.59755
Expected RN Staffing Hours per Resident per Day
0.96550
Expected Total Nurse Staffing Hours per Resident per Day
4.09102
Adjusted CNA Staffing Hours per Resident per Day
2.13679
Adjusted LPN Staffing Hours per Resident per Day
1.72196
Adjusted RN Staffing Hours per Resident per Day
1.48862
Adjusted Total Nurse Staffing Hours per Resident per Day
5.28587
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2015-04-20
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
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
16
Cycle 2 Standard Health Survey Date
2014-05-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
13
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
96
Cycle 3 Standard Health Survey Date
2013-04-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
96
Total Weighted Health Survey Score
37.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
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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Nursiong Homes Nearby
Golden Living Center-knox
300 E Culver Rd |
KNOX IN 46534 | 0.3 mile away