Diversicare Of Providence - New Albany Nursing Home
General Information
UPDATEFederal Provider Number
155668
Provider Name
DIVERSICARE OF PROVIDENCE
Provider Address
4915 CHARLESTOWN RD
NEW ALBANY, IN 47150
NEW ALBANY, IN 47150
Provider Phone Number
(812) 945-5221
Provider SSA County
210
Provider County Name
Floyd
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
158
Number of Residents in Certified Beds
136
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
Y
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1999-11-12
Continuing Care Retirement Community
Y
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
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
2.15478
Reported LPN Staffing Hours per Resident per Day
1.46949
Reported RN Staffing Hours per Resident per Day
0.50441
Reported Licensed Staffing Hours per Resident per Day
1.97390
Reported Total Nurse Staffing Hours per Resident per Day
4.12868
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12610
Expected CNA Staffing Hours per Resident per Day
2.54874
Expected LPN Staffing Hours per Resident per Day
0.65033
Expected RN Staffing Hours per Resident per Day
1.13617
Expected Total Nurse Staffing Hours per Resident per Day
4.33524
Adjusted CNA Staffing Hours per Resident per Day
2.07443
Adjusted LPN Staffing Hours per Resident per Day
1.87546
Adjusted RN Staffing Hours per Resident per Day
0.33172
Adjusted Total Nurse Staffing Hours per Resident per Day
3.83884
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2015-04-10
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2014-04-30
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
44
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
20
Cycle 3 Standard Health Survey Date
2013-02-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
20
Total Weighted Health Survey Score
22.00000
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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