Clark Rehabilitation And Skilled Nursing Center - Clarksville Nursing Home
General Information
UPDATEFederal Provider Number
155697
Provider Name
CLARK REHABILITATION AND SKILLED NURSING CENTER
Provider Address
517 N LITTLE LEAGUE BLVD
CLARKSVILLE, IN 47129
CLARKSVILLE, IN 47129
Provider Phone Number
(812) 282-8406
Provider SSA County
90
Provider County Name
Clark
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
83
Number of Residents in Certified Beds
73
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY
Date First Approved to Provide Medicare and Medicaid services
2002-06-13
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
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
3.32808
Reported LPN Staffing Hours per Resident per Day
0.48836
Reported RN Staffing Hours per Resident per Day
1.03699
Reported Licensed Staffing Hours per Resident per Day
1.52534
Reported Total Nurse Staffing Hours per Resident per Day
4.85343
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12260
Expected CNA Staffing Hours per Resident per Day
3.00948
Expected LPN Staffing Hours per Resident per Day
0.87401
Expected RN Staffing Hours per Resident per Day
1.45365
Expected Total Nurse Staffing Hours per Resident per Day
5.33715
Adjusted CNA Staffing Hours per Resident per Day
2.71346
Adjusted LPN Staffing Hours per Resident per Day
0.46377
Adjusted RN Staffing Hours per Resident per Day
0.53303
Adjusted Total Nurse Staffing Hours per Resident per Day
3.66557
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2015-05-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2014-05-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
31
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
30
Cycle 3 Health Deficiency Score
184
Cycle 3 Standard Health Survey Date
2013-05-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
184
Total Weighted Health Survey Score
42.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
25
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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