Catherine Kasper Home - Donaldson Nursing Home
General Information
UPDATEFederal Provider Number
155700
Provider Name
CATHERINE KASPER HOME
Provider Address
9601 S UNION RD
DONALDSON, IN 46513
DONALDSON, IN 46513
Provider Phone Number
(574) 935-1742
Provider SSA County
490
Provider County Name
Marshall
Provider Website
Provider Description
Ownership Type
Non profit - Church related
Number of Certified Beds
81
Number of Residents in Certified Beds
47
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
CATHERINE KASPER LIFE CENTER INC
Date First Approved to Provide Medicare and Medicaid services
2002-06-28
Continuing Care Retirement Community
Y
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
3.86596
Reported LPN Staffing Hours per Resident per Day
1.43404
Reported RN Staffing Hours per Resident per Day
1.57766
Reported Licensed Staffing Hours per Resident per Day
3.01170
Reported Total Nurse Staffing Hours per Resident per Day
6.87766
Reported Physical Therapist Staffing Hours per Resident Per Day
0.13085
Expected CNA Staffing Hours per Resident per Day
2.20267
Expected LPN Staffing Hours per Resident per Day
0.56951
Expected RN Staffing Hours per Resident per Day
0.88197
Expected Total Nurse Staffing Hours per Resident per Day
3.65415
Adjusted CNA Staffing Hours per Resident per Day
4.30654
Adjusted LPN Staffing Hours per Resident per Day
2.08997
Adjusted RN Staffing Hours per Resident per Day
1.33658
Adjusted Total Nurse Staffing Hours per Resident per Day
7.58676
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2014-04-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-02-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
20
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2011-12-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
25.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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