Garden Villa - Bloomington - Bloomington Nursing Home
General Information
UPDATEFederal Provider Number
155019
Provider Name
GARDEN VILLA - BLOOMINGTON
Provider Address
1100 S CURRY PK
BLOOMINGTON, IN 47403
BLOOMINGTON, IN 47403
Provider Phone Number
(812) 339-1657
Provider SSA County
520
Provider County Name
Monroe
Provider Website
Provider Description
Ownership Type
Non profit - Other
Number of Certified Beds
224
Number of Residents in Certified Beds
182
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
COLUMBUS REGIONAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1967-01-01
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
3
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
2.44148
Reported LPN Staffing Hours per Resident per Day
1.25440
Reported RN Staffing Hours per Resident per Day
0.87115
Reported Licensed Staffing Hours per Resident per Day
2.12555
Reported Total Nurse Staffing Hours per Resident per Day
4.56703
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00000
Expected CNA Staffing Hours per Resident per Day
2.48708
Expected LPN Staffing Hours per Resident per Day
0.66572
Expected RN Staffing Hours per Resident per Day
1.03833
Expected Total Nurse Staffing Hours per Resident per Day
4.19112
Adjusted CNA Staffing Hours per Resident per Day
2.40872
Adjusted LPN Staffing Hours per Resident per Day
1.56395
Adjusted RN Staffing Hours per Resident per Day
0.62690
Adjusted Total Nurse Staffing Hours per Resident per Day
4.39244
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2014-09-16
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-07-19
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
32
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-04-18
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
26
Cycle 3 Total Health Score
78
Total Weighted Health Survey Score
37.66700
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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