Lakeland Skilled Nursing and Rehabilitation
500 N Williams St, Angola, IN 46703


Lakeland Skilled Nursing and Rehabilitation is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 155596. The address is 500 N Williams St, Angola, IN 46703. The zip code is 46703. The phone number is 2606652161.


Lakeland Skilled Nursing and Rehabilitation · 500 N Williams St, Angola, IN 46703

Federal Provider Number 155596
Provider Name LAKELAND SKILLED NURSING AND REHABILITATION
Address 500 N WILLIAMS ST
ANGOLA, IN 46703
Phone Number 2606652161
SSA County Code 750
County Name Steuben
Ownership Type For profit - Corporation
Certified Beds 75
Certified Beds Residents 64
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name HENRY COUNTY MEMORIAL HOSPITAL
Date First Approved to Provide Medicare Medicaid Services 06/01/1996
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 Both
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 5
Health Inspection Rating 5
Quality Measure Rating 5
Staffing Rating 3
RN Staffing Rating 3
Reported CNA Staffing Hours per Resident per Day 1.9375
Reported LPN Staffing Hours per Resident per Day 0.84297
Reported RN Staffing Hours per Resident per Day 0.55938
Reported Licensed Staffing Hours per Resident per Day 1.40234
Reported Total Nurse Staffing Hours per Resident per Day 3.33985
Reported Physical Therapist Staffing Hours per Resident Per Day 0.06563
Expected CNA Staffing Hours per Resident per Day 2.30295
Expected LPN Staffing Hours per Resident per Day 0.61417
Expected RN Staffing Hours per Resident per Day 1.08659
Expected Total Nurse Staffing Hours per Resident per Day 4.00371
Adjusted CNA Staffing Hours per Resident per Day 2.06433
Adjusted LPN Staffing Hours per Resident per Day 1.1392
Adjusted RN Staffing Hours per Resident per Day 0.38466
Adjusted Total Nurse Staffing Hours per Resident per Day 3.36253
Cycle 1 Standard Survey Health Date 07/01/2016
Cycle 2 Standard Health Survey Date 06/11/2015
Cycle 3 Total Number of Health Deficiencies 2
Cycle 3 Number of Standard Health Deficiencies 1
Cycle 3 Number of Complaint Health Deficiencies 1
Cycle 3 Health Deficiency Score 8
Cycle 3 Standard Health Survey Date 07/11/2014
Cycle 3 Number of Health Revisits 1
Cycle 3 Total Health Score 8
Total Weighted Health Survey Score 1.333
Number of Substantiated Complaints 1
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Lakeland Skilled Nursing and Rehabilitation

Owner Name Role Association Date
BRAMMER, DUANE (Individual) DIRECTOR since 09/04/2014
BRAMMER, DUANE (Individual) OFFICER since 09/04/2014
COVENANT CARE CALIFORNIA, LLC (Organization) OPERATIONAL/MANAGERIAL CONTROL since 09/04/2014
DYNES, SHELDON (Individual) DIRECTOR since 09/04/2014
DYNES, SHELDON (Individual) OFFICER since 09/04/2014
FERGUSON, MARTHA (Individual) MANAGING EMPLOYEE since 09/04/2014
HENRY COUNTY MEMORIAL HOSPITAL (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 09/04/2014
JANSSEN, PAUL (Individual) DIRECTOR since 09/04/2014
JANSSEN, PAUL (Individual) OFFICER since 09/04/2014
LEVIN, ROBERT (Individual) OFFICER since 09/04/2014
LEVIN, ROBERT (Individual) OPERATIONAL/MANAGERIAL CONTROL since 09/04/2014
PIDGEON, JOHN (Individual) DIRECTOR since 09/04/2014
PIDGEON, JOHN (Individual) OFFICER since 09/04/2014
PRIVETT, JUDITH (Individual) MANAGING EMPLOYEE since 09/04/2014
SHORE, MARION (Individual) DIRECTOR since 09/04/2014

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Northern Lakes Nursing and Rehabilitation Center 516 N Williams St, Angola, IN 46703

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