Especially Kidz Health & Rehab - Shelbyville Nursing Home
General Information
UPDATEFederal Provider Number
15A011
Provider Name
ESPECIALLY KIDZ HEALTH & REHAB
Provider Address
2325 S MILLER ST
SHELBYVILLE, IN 46176
SHELBYVILLE, IN 46176
Provider Phone Number
3173923287
Provider SSA County
720
Provider County Name
Shelby
Ownership Type
Non profit - Corporation
Number of Certified Beds
130
Number of Residents in Certified Beds
126
Provider Type
Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1974-03-31
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
4
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.60595
Reported LPN Staffing Hours per Resident per Day
0.82302
Reported RN Staffing Hours per Resident per Day
0.60952
Reported Licensed Staffing Hours per Resident per Day
1.43254
Reported Total Nurse Staffing Hours per Resident per Day
4.03849
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00913
Expected CNA Staffing Hours per Resident per Day
2.97340
Expected LPN Staffing Hours per Resident per Day
1.45438
Expected RN Staffing Hours per Resident per Day
1.91375
Expected Total Nurse Staffing Hours per Resident per Day
6.34152
Adjusted CNA Staffing Hours per Resident per Day
2.15048
Adjusted LPN Staffing Hours per Resident per Day
0.46969
Adjusted RN Staffing Hours per Resident per Day
0.23798
Adjusted Total Nurse Staffing Hours per Resident per Day
2.56701
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2014-04-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-02-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
24
Cycle 3 Standard Health Survey Date
2011-12-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
22.66700
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
Nursiong Homes Nearby
Heritage House Of Shelbyville
2309 S Miller St |
SHELBYVILLE IN 46176 | 0.1 mile away
Ashford Place Health Campus
2200 N Riley Hwy |
SHELBYVILLE IN 46176 | 3.9 miles away
Waldron Health And Rehab Center
505 N Main St |
WALDRON IN 46182 | 7.1 miles away
Morristown Manor
868 S Washington St |
MORRISTOWN IN 46161 | 12.1 miles away
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