Woodbridge Health Campus - Logansport Nursing Home
General Information
UPDATEFederal Provider Number
155724
Provider Name
WOODBRIDGE HEALTH CAMPUS
Provider Address
602 WOODBRIDGE AVE
LOGANSPORT, IN 46947
LOGANSPORT, IN 46947
Provider Phone Number
(574) 753-3223
Provider SSA County
80
Provider County Name
Cass
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
69
Number of Residents in Certified Beds
60
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TRILOGY HEALTHCARE OF LOGANSPORT LLC
Date First Approved to Provide Medicare and Medicaid services
2003-07-03
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
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
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
2.50917
Reported LPN Staffing Hours per Resident per Day
0.97083
Reported RN Staffing Hours per Resident per Day
0.65083
Reported Licensed Staffing Hours per Resident per Day
1.62167
Reported Total Nurse Staffing Hours per Resident per Day
4.13083
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09500
Expected CNA Staffing Hours per Resident per Day
2.38375
Expected LPN Staffing Hours per Resident per Day
0.65358
Expected RN Staffing Hours per Resident per Day
1.18313
Expected Total Nurse Staffing Hours per Resident per Day
4.22046
Adjusted CNA Staffing Hours per Resident per Day
2.58280
Adjusted LPN Staffing Hours per Resident per Day
1.23289
Adjusted RN Staffing Hours per Resident per Day
0.41103
Adjusted Total Nurse Staffing Hours per Resident per Day
3.94529
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2015-03-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2014-04-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2013-02-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
24.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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