Wittenberg Lutheran Village - Crown Point Nursing Home
General Information
UPDATEFederal Provider Number
155608
Provider Name
WITTENBERG LUTHERAN VILLAGE
Provider Address
1200 E LUTHER DR
CROWN POINT, IN 46307
CROWN POINT, IN 46307
Provider Phone Number
(219) 663-3860
Provider SSA County
440
Provider County Name
Lake
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
155
Number of Residents in Certified Beds
148
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WITTENBERG LUTHERAN VILLAGE
Date First Approved to Provide Medicare and Medicaid services
1997-01-01
Continuing Care Retirement Community
Y
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
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
2.13243
Reported LPN Staffing Hours per Resident per Day
0.72601
Reported RN Staffing Hours per Resident per Day
0.84426
Reported Licensed Staffing Hours per Resident per Day
1.57027
Reported Total Nurse Staffing Hours per Resident per Day
3.70270
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07534
Expected CNA Staffing Hours per Resident per Day
2.51182
Expected LPN Staffing Hours per Resident per Day
0.68102
Expected RN Staffing Hours per Resident per Day
1.13636
Expected Total Nurse Staffing Hours per Resident per Day
4.32920
Adjusted CNA Staffing Hours per Resident per Day
2.08309
Adjusted LPN Staffing Hours per Resident per Day
0.88483
Adjusted RN Staffing Hours per Resident per Day
0.55513
Adjusted Total Nurse Staffing Hours per Resident per Day
3.44756
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-02-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
15
Cycle 2 Number of Standard Health Deficiencies
15
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
92
Cycle 2 Standard Health Survey Date
2013-01-16
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
92
Cycle 3 Total Number of Health Deficiencies
13
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2011-10-19
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
32
Cycle 3 Total Health Score
96
Total Weighted Health Survey Score
74.66700
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
19
Number of Fines
1
Total Amount of Fines in Dollars
7313
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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