Caroleton Manor - Connersville Nursing Home
General Information
UPDATEFederal Provider Number
155387
Provider Name
CAROLETON MANOR
Provider Address
2500 IOWA AVE
CONNERSVILLE, IN 47331
CONNERSVILLE, IN 47331
Provider Phone Number
(765) 825-7514
Provider SSA County
200
Provider County Name
Fayette
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
50
Number of Residents in Certified Beds
47
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ADAMS COUNTY MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1991-09-03
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
3
QM Rating Footnote
Staffing Rating
1
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
1.96489
Reported LPN Staffing Hours per Resident per Day
0.62447
Reported RN Staffing Hours per Resident per Day
0.42234
Reported Licensed Staffing Hours per Resident per Day
1.04681
Reported Total Nurse Staffing Hours per Resident per Day
3.01170
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06064
Expected CNA Staffing Hours per Resident per Day
2.60905
Expected LPN Staffing Hours per Resident per Day
0.72540
Expected RN Staffing Hours per Resident per Day
1.10384
Expected Total Nurse Staffing Hours per Resident per Day
4.43829
Adjusted CNA Staffing Hours per Resident per Day
1.84789
Adjusted LPN Staffing Hours per Resident per Day
0.71452
Adjusted RN Staffing Hours per Resident per Day
0.28589
Adjusted Total Nurse Staffing Hours per Resident per Day
2.73526
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-10-31
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-11-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-09-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
31.33300
Number of Facility Reported Incidents
4
Number of Substantiated Complaints
0
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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