Evansville Protestant Home Inc - Evansville Nursing Home
General Information
UPDATEFederal Provider Number
155768
Provider Name
EVANSVILLE PROTESTANT HOME INC
Provider Address
3701 WASHINGTON AVE
EVANSVILLE, IN 47714
EVANSVILLE, IN 47714
Provider Phone Number
(812) 476-3360
Provider SSA County
810
Provider County Name
Vanderburgh
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
49
Number of Residents in Certified Beds
39
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EVANSVILLE PROTESTANT HOME INC
Date First Approved to Provide Medicare and Medicaid services
2008-06-13
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
2
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
1.71795
Reported LPN Staffing Hours per Resident per Day
1.22692
Reported RN Staffing Hours per Resident per Day
0.79103
Reported Licensed Staffing Hours per Resident per Day
2.01795
Reported Total Nurse Staffing Hours per Resident per Day
3.73590
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.49448
Expected LPN Staffing Hours per Resident per Day
0.62774
Expected RN Staffing Hours per Resident per Day
0.96801
Expected Total Nurse Staffing Hours per Resident per Day
4.09023
Adjusted CNA Staffing Hours per Resident per Day
1.68986
Adjusted LPN Staffing Hours per Resident per Day
1.62224
Adjusted RN Staffing Hours per Resident per Day
0.61059
Adjusted Total Nurse Staffing Hours per Resident per Day
3.68171
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2015-02-23
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2014-03-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2013-05-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
26.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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