Golden Living Center-sycamore Village - Kokomo Nursing Home
General Information
UPDATEFederal Provider Number
155367
Provider Name
GOLDEN LIVING CENTER-SYCAMORE VILLAGE
Provider Address
2905 W SYCAMORE ST
KOKOMO, IN 46901
KOKOMO, IN 46901
Provider Phone Number
(765) 452-5491
Provider SSA County
330
Provider County Name
Howard
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
110
Number of Residents in Certified Beds
94
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HENDRICKS COUNTY HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1990-11-19
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.91223
Reported LPN Staffing Hours per Resident per Day
0.83936
Reported RN Staffing Hours per Resident per Day
0.70904
Reported Licensed Staffing Hours per Resident per Day
1.54840
Reported Total Nurse Staffing Hours per Resident per Day
3.46063
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06064
Expected CNA Staffing Hours per Resident per Day
2.36470
Expected LPN Staffing Hours per Resident per Day
0.61849
Expected RN Staffing Hours per Resident per Day
1.03953
Expected Total Nurse Staffing Hours per Resident per Day
4.02272
Adjusted CNA Staffing Hours per Resident per Day
1.98420
Adjusted LPN Staffing Hours per Resident per Day
1.12640
Adjusted RN Staffing Hours per Resident per Day
0.50965
Adjusted Total Nurse Staffing Hours per Resident per Day
3.46766
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
6
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-09-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
13
Cycle 2 Number of Standard Health Deficiencies
13
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2013-08-02
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
68
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
72
Cycle 3 Standard Health Survey Date
2012-06-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
72
Total Weighted Health Survey Score
58.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
8
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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