Brookville Healthcare Center - Brookville Nursing Home
General Information
UPDATEFederal Provider Number
155480
Provider Name
BROOKVILLE HEALTHCARE CENTER
Provider Address
11049 SR 101
BROOKVILLE, IN 47012
BROOKVILLE, IN 47012
Provider Phone Number
(765) 647-2527
Provider SSA County
230
Provider County Name
Franklin
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
100
Number of Residents in Certified Beds
64
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
1992-11-01
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
2
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
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
2.21094
Reported LPN Staffing Hours per Resident per Day
1.49844
Reported RN Staffing Hours per Resident per Day
0.51250
Reported Licensed Staffing Hours per Resident per Day
2.01094
Reported Total Nurse Staffing Hours per Resident per Day
4.22188
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02266
Expected CNA Staffing Hours per Resident per Day
2.66003
Expected LPN Staffing Hours per Resident per Day
0.75462
Expected RN Staffing Hours per Resident per Day
1.19166
Expected Total Nurse Staffing Hours per Resident per Day
4.60631
Adjusted CNA Staffing Hours per Resident per Day
2.03945
Adjusted LPN Staffing Hours per Resident per Day
1.64812
Adjusted RN Staffing Hours per Resident per Day
0.32135
Adjusted Total Nurse Staffing Hours per Resident per Day
3.69449
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2015-04-10
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2014-02-24
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
12
Cycle 3 Number of Standard Health Deficiencies
8
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2013-03-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
30.66700
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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