Clearvista Lake Health Campus - Indianapolis Nursing Home
General Information
UPDATEFederal Provider Number
155815
Provider Name
CLEARVISTA LAKE HEALTH CAMPUS
Provider Address
8405 CLEARVISTA PLACE
INDIANAPOLIS, IN 46256
INDIANAPOLIS, IN 46256
Provider Phone Number
(317) 578-7500
Provider SSA County
480
Provider County Name
Marion
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
70
Number of Residents in Certified Beds
58
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
RHS PARTNERS OF CASTLETON LLC
Date First Approved to Provide Medicare and Medicaid services
2014-02-26
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
3
Overall Rating Footnote
Health Inspection Rating
2
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
2.40086
Reported LPN Staffing Hours per Resident per Day
1.70172
Reported RN Staffing Hours per Resident per Day
1.22672
Reported Licensed Staffing Hours per Resident per Day
2.92845
Reported Total Nurse Staffing Hours per Resident per Day
5.32930
Reported Physical Therapist Staffing Hours per Resident Per Day
0.31034
Expected CNA Staffing Hours per Resident per Day
2.31185
Expected LPN Staffing Hours per Resident per Day
0.68230
Expected RN Staffing Hours per Resident per Day
1.41080
Expected Total Nurse Staffing Hours per Resident per Day
4.40495
Adjusted CNA Staffing Hours per Resident per Day
2.54817
Adjusted LPN Staffing Hours per Resident per Day
2.07011
Adjusted RN Staffing Hours per Resident per Day
0.64971
Adjusted Total Nurse Staffing Hours per Resident per Day
4.87676
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
68
Cycle 1 Standard Survey Health Date
2015-02-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
68
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2014-02-26
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
0000-00-00
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
47.20000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
7
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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