Indiana Nursing Homes >> Princeton Nursing Homes >> Gibson General Hospital-snf

Gibson General Hospital-snf - Princeton Nursing Home

General Information

UPDATE
Federal Provider Number
155093
Provider Name
GIBSON GENERAL HOSPITAL-SNF
Provider Address
1808 SHERMAN DR
PRINCETON, IN 47670
Provider Phone Number
(812) 385-9288
Provider SSA County
250
Provider County Name
Gibson
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
45
Number of Residents in Certified Beds
42
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PERRY COUNTY MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1969-05-13
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
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
3
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.76310
Reported LPN Staffing Hours per Resident per Day
0.62857
Reported RN Staffing Hours per Resident per Day
1.32024
Reported Licensed Staffing Hours per Resident per Day
1.94881
Reported Total Nurse Staffing Hours per Resident per Day
3.71191
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00833
Expected CNA Staffing Hours per Resident per Day
2.37742
Expected LPN Staffing Hours per Resident per Day
0.60379
Expected RN Staffing Hours per Resident per Day
0.84194
Expected Total Nurse Staffing Hours per Resident per Day
3.82315
Adjusted CNA Staffing Hours per Resident per Day
1.81967
Adjusted LPN Staffing Hours per Resident per Day
0.86406
Adjusted RN Staffing Hours per Resident per Day
1.17168
Adjusted Total Nurse Staffing Hours per Resident per Day
3.91361
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
36
Cycle 1 Standard Survey Health Date
2015-04-23
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
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
36
Cycle 2 Standard Health Survey Date
2014-02-20
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
8
Cycle 3 Standard Health Survey Date
2013-04-03
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
31.33300
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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