Signature Healthcare of Bremen
316 Woodies Ln, Bremen, IN 46506


Signature Healthcare of Bremen is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 155474. The address is 316 Woodies Ln, Bremen, IN 46506. The zip code is 46506. The phone number is 5745463494.


Signature Healthcare of Bremen · 316 Woodies Ln, Bremen, IN 46506

Federal Provider Number 155474
Provider Name SIGNATURE HEALTHCARE OF BREMEN
Address 316 WOODIES LN
BREMEN, IN 46506
Phone Number 5745463494
SSA County Code 490
County Name Marshall
Ownership Type Government - County
Certified Beds 97
Certified Beds Residents 69
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name JACKSON COUNTY SCHNECK MEMORIAL HOSPITAL
Date First Approved to Provide Medicare Medicaid Services 10/27/1992
Continuing Care Retirement Community false
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 2
Health Inspection Rating 2
Quality Measure Rating 4
Staffing Rating 3
RN Staffing Rating 4
Reported CNA Staffing Hours per Resident per Day 2.08696
Reported LPN Staffing Hours per Resident per Day 0.78913
Reported RN Staffing Hours per Resident per Day 0.80725
Reported Licensed Staffing Hours per Resident per Day 1.59638
Reported Total Nurse Staffing Hours per Resident per Day 3.68334
Reported Physical Therapist Staffing Hours per Resident Per Day 0.06594
Expected CNA Staffing Hours per Resident per Day 2.53672
Expected LPN Staffing Hours per Resident per Day 0.63442
Expected RN Staffing Hours per Resident per Day 1.06729
Expected Total Nurse Staffing Hours per Resident per Day 4.23844
Adjusted CNA Staffing Hours per Resident per Day 2.01866
Adjusted LPN Staffing Hours per Resident per Day 1.0324
Adjusted RN Staffing Hours per Resident per Day 0.56515
Adjusted Total Nurse Staffing Hours per Resident per Day 3.50298
Cycle 1 Total Number of Health Deficiencies 12
Cycle 1 Number of Standard Health Deficiencies 7
Cycle 1 Number of Complaint Health Deficiencies 5
Cycle 1 Health Deficiency Score 48
Cycle 1 Standard Survey Health Date 10/28/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 48
Cycle 2 Total Number of Health Deficiencies 10
Cycle 2 Number of Standard Health Deficiencies 10
Cycle 2 Health Deficiency Score 60
Cycle 2 Standard Health Survey Date 10/07/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 60
Cycle 3 Total Number of Health Deficiencies 9
Cycle 3 Number of Standard Health Deficiencies 9
Cycle 3 Health Deficiency Score 48
Cycle 3 Standard Health Survey Date 08/15/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 48
Total Weighted Health Survey Score 52
Number of Substantiated Complaints 9
Number of Fines 1
Total Amount of Fines in Dollars $1300.00
Total Number of Penalties 1
Processing Date 08/01/2017

Owner or Manager · Signature Healthcare of Bremen

Owner Name Role Association Date
COOK, ANGELA (Individual) MANAGING EMPLOYEE since 05/01/2014
DOUGLAS, DEBORAH (Individual) MANAGING EMPLOYEE since 05/01/2014
FORGEY, WARREN (Individual) MANAGING EMPLOYEE since 04/03/2015
FORGEY, WARREN (Individual) OFFICER since 04/03/2015
GILLILAND, TERRENCE (Individual) DIRECTOR since 05/01/2014
HILL, DOUG (Individual) DIRECTOR since 05/01/2014
HOUNSHEL, JERRY (Individual) DIRECTOR since 05/01/2014
JACKSON COUNTY SCHNECK MEMORIAL HOSPITAL (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 05/01/2014
JORAY, THOMAS (Individual) DIRECTOR since 05/01/2014
KLEBER, COURTNEY (Individual) DIRECTOR since 05/01/2014
MANN, DEBORAH (Individual) MANAGING EMPLOYEE since 02/10/2014
MANN, DEBORAH (Individual) OFFICER since 03/01/2015
MCCORY, JACK (Individual) DIRECTOR since 05/01/2014
MCCOY, JOHN (Individual) DIRECTOR since 05/01/2014
REEDY, MATTHEW (Individual) DIRECTOR since 05/01/2014
SMITH, RICK (Individual) DIRECTOR since 05/01/2014

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