Wellbrooke Of Avon - Indianapolis Nursing Home
General Information
UPDATEFederal Provider Number
155811
Provider Name
WELLBROOKE OF AVON
Provider Address
10307 EAST COUNTY ROAD 100 NORTH
INDIANAPOLIS, IN 46234
INDIANAPOLIS, IN 46234
Provider Phone Number
3172732144
Provider SSA County
480
Provider County Name
Marion
Ownership Type
For profit - Corporation
Number of Certified Beds
70
Number of Residents in Certified Beds
54
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LCS AVON LLC
Date First Approved to Provide Medicare and Medicaid services
2013-10-23
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
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.59630
Reported LPN Staffing Hours per Resident per Day
1.11944
Reported RN Staffing Hours per Resident per Day
2.03148
Reported Licensed Staffing Hours per Resident per Day
3.15093
Reported Total Nurse Staffing Hours per Resident per Day
5.74722
Reported Physical Therapist Staffing Hours per Resident Per Day
0.21204
Expected CNA Staffing Hours per Resident per Day
2.48346
Expected LPN Staffing Hours per Resident per Day
0.70978
Expected RN Staffing Hours per Resident per Day
1.44576
Expected Total Nurse Staffing Hours per Resident per Day
4.63899
Adjusted CNA Staffing Hours per Resident per Day
2.56519
Adjusted LPN Staffing Hours per Resident per Day
1.30905
Adjusted RN Staffing Hours per Resident per Day
1.04992
Adjusted Total Nurse Staffing Hours per Resident per Day
4.99386
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-11-13
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2013-10-23
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
-0001-11-30
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
19.20000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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