Alexandria Care Center - Alexandria Nursing Home
General Information
UPDATEFederal Provider Number
155521
Provider Name
ALEXANDRIA CARE CENTER
Provider Address
1912 S PARK AVE
ALEXANDRIA, IN 46001
ALEXANDRIA, IN 46001
Provider Phone Number
7657244478
Provider SSA County
470
Provider County Name
Madison
Ownership Type
Government - County
Number of Certified Beds
70
Number of Residents in Certified Beds
59
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WITHAM MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1994-07-01
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
3
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.33051
Reported LPN Staffing Hours per Resident per Day
0.91949
Reported RN Staffing Hours per Resident per Day
0.51441
Reported Licensed Staffing Hours per Resident per Day
1.43390
Reported Total Nurse Staffing Hours per Resident per Day
3.76441
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09661
Expected CNA Staffing Hours per Resident per Day
2.41800
Expected LPN Staffing Hours per Resident per Day
0.66531
Expected RN Staffing Hours per Resident per Day
1.08062
Expected Total Nurse Staffing Hours per Resident per Day
4.16394
Adjusted CNA Staffing Hours per Resident per Day
2.36492
Adjusted LPN Staffing Hours per Resident per Day
1.14709
Adjusted RN Staffing Hours per Resident per Day
0.35569
Adjusted Total Nurse Staffing Hours per Resident per Day
3.64414
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2014-11-24
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
6
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2014-01-08
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
3
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-11-19
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
19.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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