Summerfield Health Care Center
34 S Main St, Cloverdale, IN 46120


Summerfield Health Care Center is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 155587. The address is 34 S Main St, Cloverdale, IN 46120. The zip code is 46120. The phone number is 7657954260.


Summerfield Health Care Center · 34 S Main St, Cloverdale, IN 46120

Federal Provider Number 155587
Provider Name SUMMERFIELD HEALTH CARE CENTER
Address 34 S MAIN ST
CLOVERDALE, IN 46120
Phone Number 7657954260
SSA County Code 660
County Name Putnam
Ownership Type Non profit - Other
Certified Beds 43
Certified Beds Residents 42
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name PUTNAM COUNTY HOSPITAL
Date First Approved to Provide Medicare Medicaid Services 11/01/1995
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 5
Health Inspection Rating 5
Quality Measure Rating 3
Staffing Rating 2
RN Staffing Rating 4
Reported CNA Staffing Hours per Resident per Day 1.90476
Reported LPN Staffing Hours per Resident per Day 0.44881
Reported RN Staffing Hours per Resident per Day 0.77619
Reported Licensed Staffing Hours per Resident per Day 1.225
Reported Total Nurse Staffing Hours per Resident per Day 3.12976
Reported Physical Therapist Staffing Hours per Resident Per Day 0.01667
Expected CNA Staffing Hours per Resident per Day 2.5267
Expected LPN Staffing Hours per Resident per Day 0.58227
Expected RN Staffing Hours per Resident per Day 0.90594
Expected Total Nurse Staffing Hours per Resident per Day 4.01491
Adjusted CNA Staffing Hours per Resident per Day 1.84973
Adjusted LPN Staffing Hours per Resident per Day 0.63976
Adjusted RN Staffing Hours per Resident per Day 0.64018
Adjusted Total Nurse Staffing Hours per Resident per Day 3.14222
Cycle 1 Total Number of Health Deficiencies 1
Cycle 1 Number of Standard Health Deficiencies 1
Cycle 1 Health Deficiency Score 4
Cycle 1 Standard Survey Health Date 07/26/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 4
Cycle 2 Total Number of Health Deficiencies 3
Cycle 2 Number of Standard Health Deficiencies 3
Cycle 2 Health Deficiency Score 12
Cycle 2 Standard Health Survey Date 06/24/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 12
Cycle 3 Standard Health Survey Date 06/10/2014
Total Weighted Health Survey Score 6
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Summerfield Health Care Center

Owner Name Role Association Date
BRAY, ARNOLD (Individual) DIRECTOR since 12/01/2012
BRIDGEWATERS, NEDRA (Individual) MANAGING EMPLOYEE since 06/16/2015
CHOSEN CONSULTING INC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 09/01/2014
ERNST, KEITH (Individual) DIRECTOR since 12/01/2012
FRY, JANICE (Individual) DIRECTOR since 12/01/2012
HEADLEY, MATTHEW (Individual) DIRECTOR since 12/01/2012
HEAVIN, ROBERT (Individual) DIRECTOR since 12/01/2012
HORNSTEIN, GEORGE (Individual) MANAGING EMPLOYEE since 12/04/2014
MANN, ROBERT (Individual) DIRECTOR since 01/01/2016
O'HAIR, DENNIS (Individual) DIRECTOR since 12/01/2012
ORLINSKY, MOSHE (Individual) OFFICER since 01/01/2016
PERKINS, JONI (Individual) MANAGING EMPLOYEE since 12/01/2012
PUTNAM COUNTY HOSPITAL (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 12/01/2012
WEATHERFORD, DENNIS (Individual) MANAGING EMPLOYEE since 12/01/2012
WEATHERFORD, DENNIS (Individual) OFFICER since 12/01/2012
WEATHERFORD, DENNIS (Individual) OPERATIONAL/MANAGERIAL CONTROL since 12/01/2012

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