Indiana Nursing Homes >> Seymour Nursing Homes >> Covered Bridge Health Campus

Covered Bridge Health Campus - Seymour Nursing Home

General Information

UPDATE
Federal Provider Number
155712
Provider Name
COVERED BRIDGE HEALTH CAMPUS
Provider Address
1675 W TIPTON ST
SEYMOUR, IN 47274
Provider Phone Number
(812) 523-6405
Provider SSA County
350
Provider County Name
Jackson
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
78
Number of Residents in Certified Beds
57
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
2002-10-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
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
3
Health Inspection Rating Footnote
QM Rating
3
QM Rating Footnote
Staffing Rating
3
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
1.76842
Reported LPN Staffing Hours per Resident per Day
0.37193
Reported RN Staffing Hours per Resident per Day
1.61579
Reported Licensed Staffing Hours per Resident per Day
1.98772
Reported Total Nurse Staffing Hours per Resident per Day
3.75614
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09035
Expected CNA Staffing Hours per Resident per Day
2.40994
Expected LPN Staffing Hours per Resident per Day
0.66253
Expected RN Staffing Hours per Resident per Day
1.16562
Expected Total Nurse Staffing Hours per Resident per Day
4.23809
Adjusted CNA Staffing Hours per Resident per Day
1.80053
Adjusted LPN Staffing Hours per Resident per Day
0.46594
Adjusted RN Staffing Hours per Resident per Day
1.03578
Adjusted Total Nurse Staffing Hours per Resident per Day
3.57251
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2015-01-27
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
28
Cycle 2 Standard Health Survey Date
2013-11-20
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
14
Cycle 3 Number of Standard Health Deficiencies
14
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2012-08-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
31.33300
Number of Facility Reported Incidents
0
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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