LIFE CARE CENTER OF VALPARAISO - VALPARAISO, IN
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LIFE CARE CENTER OF VALPARAISO
3405 N CAMPBELL RD VALPARAISO, IN 46385 RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTIONS SNF/NF (DISTINCT PART) Services provided by LIFE CARE CENTER OF VALPARAISO:
Beds - Total (Total number of beds in a facility, including those in non-Participating or non-licensed areas): 110 Beds - Total certified (Number of beds in Medicare and/or Medicaid certified areas within a facility): 100 Beds - Nursing facility (Number of Medicaid certified skilled nursing care beds in a facility): 70 Lpn/lvn - Full time (The number of full-time equivalent licensed practical/ vocational nurses employed by a facility on a full time basis): 12.57 Registered nurse - Full time (The number of full-time equivalent registered nurses employed by a facility on a full time basis): 5 Current fms survey date (Current fms survey date): Jun 1999 Program participation (Indicates if the provider participates in Medicare, Medicaid, or both programs): MEDICARE AND MEDICAID Regional override #2 (staffing) (This field is set to "y" when the regional office has to ok a pending record in the special fields screen. this field only applies to categories in the odie data entry system): Yes Activity professional - Full time (The number of full-time equivalent activities professionals employed full time by a facility): 1.14 Administrator - Full time (The number of full-time equivalent administrative staff employed on a full time basis by a facility): 8.57 Beds - Medicare snf (Number of Medicare certified snf beds in a facility): 14 Beds - Snf/nf (Number of beds certified for both Medicare and Medicaid skilled nursing care in a long term care facility): 16 Cert nurse aides - Full time (The number of full-time equivalent certified nurse aides employed by a facility on a full time basis): 25.14 Cert nurse aides - Part time (The number of full-time equivalent certified nurse aides employed by a facility on a part time basis): 2.57 Dietitians - Contract (The number of full-time equivalent under contract to a facility): 0.23 Dietitians - Full time (The number of full-time equivalent dietitians employed by a facility on a full time basis): 1.14 Food service - Full time (The number of full-time equivalent food service personnel employed by a facility on a full time basis): 6.86 Food service - Part time (The number of full-time equivalent food service personnel employed by a facility on a part time basis): 3.29 Housekeeping - Full time (The number of full-time equivalent housekeeping personnel employed by a facility on a full time basis): 5.71 Housekeeping - Part time (The number of full-time equivalent housekeeping personnel employed by a facility on a part time basis): 5.14 Lpn/lvn - Part time (The number of full-time equivalent licensed practical/ vocational nurses employed by a facility on a part time basis): 2.14 Medical director - Contract (The number of full-time equivalent medical directors under contrcat to a facility): 0.23 Medication aides/techs-Full time (The number of full-time equivalent medication aides/ technicians employed by a facility on a full time basis): 6.86 Medication aides/techs-Part time (The number of full-time equivalent medication aides/ technicians employed bya facility on a part time basis): 0.69 Multi-Facility organization owned (Indicates if a facility is owned by an organization that owns (or leases) two or more nursing facilities): Yes Nurses with admin duties-Full time (The number of full-time equivalent nurses with administrative duties employed by a facility on a full time basis): 4.57 Occup therapy aide - Part time (The number of full-time equivalent occupational therapy aides employed by a facility on a part time basis): 0.57 Occup therapy asst - Part time (The number of full-time equivalent occupational therapy assistants employed by a facility on a part time basis): 0.14 Occupational therapist - Full time (The number of full-time equivalent occupational therapists employed by a facility on a full time basis): 1.14 Organized resident group (Indicates if the facility has an organized residents group): Yes Other activities staff-Full time (Number of full-time staff hours for other activities): 1.14 Other physician - Contract (The number of full-time equivalent other physicians under contract to a facility): 0.86 Othr social serv staff-Full time (Number of full-time staff hours provided by other socia l services staff): 0.57 Pharmacists - Contract (The number of full-time equivalent pharmacists under contract to a facility): 0.11 Physical therapists - Full time (The number of full time equivalent physical therapists employed by a facility on a full time basis): 2.29 Physical therapy aide - Full time (The number of full-time equivalent physical therapy aide employed by a facility on a full time basis): 1.14 Physical therapy aide - Part time (The number of full-time equivalent physical therapy aide employed by a facility on a part time basis): 0.57 Registered nurse - Part time (The number of full-time equivalent registered nurses employed by a facility on a part time basis): 1.20 Rn director of nursing - Full time (The number of full-time equivalent rn director of nursing employed by a facility on a full time basis): 1.14 Social worker - Full time (The number of full-time equivalent social workers employed by a facility on a full time basis): 1.14 Social worker - Part time (The number of full-time equivalent social workers employed by a facility on a part time basis): 0.57 Compliance: plan of correction (Indicates if a provider is in compliance with program requirements based on an acceptable plan for correction of deficiencies): COMPLIANCE BASED ON ACCEPTABLE POC Compliance: status (Indicates if a provider or supplier is in compliance with program requirements): IN COMPLIANCE Current survey date (The date of the health or life safety code survey, whichever is later. the "official" survey date for the provider): Oct 2002 Eligibility code (Indicates if a facility is eligible to participate in the Medicare and/or Medicaid programs): ELIGIBLE TO PARTICIPATE Participation date (The date a facility is first approved to provide Medicare and/or Medicaid services): Mar 1989 |
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