Bloomington Nursing And Rehabilitation Center - Bloomington Nursing Home
General Information
UPDATEFederal Provider Number
155532
Provider Name
BLOOMINGTON NURSING AND REHABILITATION CENTER
Provider Address
120 E MILLER DR
BLOOMINGTON, IN 47401
BLOOMINGTON, IN 47401
Provider Phone Number
(812) 336-1055
Provider SSA County
520
Provider County Name
Monroe
Provider Website
Provider Description
Ownership Type
Non profit - Other
Number of Certified Beds
38
Number of Residents in Certified Beds
31
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
ADAMS COUNTY MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1994-09-30
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.57097
Reported LPN Staffing Hours per Resident per Day
0.75161
Reported RN Staffing Hours per Resident per Day
0.77419
Reported Licensed Staffing Hours per Resident per Day
1.52581
Reported Total Nurse Staffing Hours per Resident per Day
3.09677
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01129
Expected CNA Staffing Hours per Resident per Day
1.92521
Expected LPN Staffing Hours per Resident per Day
0.56830
Expected RN Staffing Hours per Resident per Day
0.97990
Expected Total Nurse Staffing Hours per Resident per Day
3.47341
Adjusted CNA Staffing Hours per Resident per Day
2.00222
Adjusted LPN Staffing Hours per Resident per Day
1.09773
Adjusted RN Staffing Hours per Resident per Day
0.59034
Adjusted Total Nurse Staffing Hours per Resident per Day
3.59381
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
92
Cycle 1 Standard Survey Health Date
2014-04-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
92
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
64
Cycle 2 Standard Health Survey Date
2013-06-03
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
32
Cycle 2 Total Health Score
96
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2012-03-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
88.00000
Number of Facility Reported Incidents
1
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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