George Ade Memorial Health Care Center - Brook Nursing Home
General Information
UPDATEFederal Provider Number
155719
Provider Name
GEORGE ADE MEMORIAL HEALTH CARE CENTER
Provider Address
3623 E SR 16
BROOK, IN 47922
BROOK, IN 47922
Provider Phone Number
2192752531
Provider SSA County
550
Provider County Name
Newton
Ownership Type
Government - County
Number of Certified Beds
70
Number of Residents in Certified Beds
61
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GEORGE ADE MEMORIAL HEALTH CARE CENTER INC.
Date First Approved to Provide Medicare and Medicaid services
2003-02-04
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
3
Overall Rating Footnote
Health Inspection Rating
2
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
2.75738
Reported LPN Staffing Hours per Resident per Day
0.92623
Reported RN Staffing Hours per Resident per Day
0.69672
Reported Licensed Staffing Hours per Resident per Day
1.62295
Reported Total Nurse Staffing Hours per Resident per Day
4.38033
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12213
Expected CNA Staffing Hours per Resident per Day
2.63321
Expected LPN Staffing Hours per Resident per Day
0.61330
Expected RN Staffing Hours per Resident per Day
0.89865
Expected Total Nurse Staffing Hours per Resident per Day
4.14516
Adjusted CNA Staffing Hours per Resident per Day
2.56940
Adjusted LPN Staffing Hours per Resident per Day
1.25350
Adjusted RN Staffing Hours per Resident per Day
0.57930
Adjusted Total Nurse Staffing Hours per Resident per Day
4.25959
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2015-01-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2014-03-06
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
14
Cycle 3 Number of Standard Health Deficiencies
14
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
80
Cycle 3 Standard Health Survey Date
2013-01-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
80
Total Weighted Health Survey Score
46.00000
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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