Miller's Merry Manor - Chesterfield Nursing Home
General Information
UPDATEFederal Provider Number
155617
Provider Name
MILLER'S MERRY MANOR
Provider Address
524 ANDERSON RD
CHESTERFIELD, IN 46017
CHESTERFIELD, IN 46017
Provider Phone Number
7653780213
Provider SSA County
470
Provider County Name
Madison
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
47
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
JOHNSON MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1996-11-01
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
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
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
1.97766
Reported LPN Staffing Hours per Resident per Day
1.19894
Reported RN Staffing Hours per Resident per Day
0.68191
Reported Licensed Staffing Hours per Resident per Day
1.88085
Reported Total Nurse Staffing Hours per Resident per Day
3.85851
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03617
Expected CNA Staffing Hours per Resident per Day
2.69155
Expected LPN Staffing Hours per Resident per Day
0.70404
Expected RN Staffing Hours per Resident per Day
1.08934
Expected Total Nurse Staffing Hours per Resident per Day
4.48493
Adjusted CNA Staffing Hours per Resident per Day
1.80289
Adjusted LPN Staffing Hours per Resident per Day
1.41344
Adjusted RN Staffing Hours per Resident per Day
0.46774
Adjusted Total Nurse Staffing Hours per Resident per Day
3.46790
Cycle 1 Total Number of Health Deficiencies
0
Cycle 1 Number of Standard Health Deficiencies
0
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
0
Cycle 1 Standard Survey Health Date
2014-07-17
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
0
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-05-31
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-03-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
9.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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