Greenwood Village South - Greenwood Nursing Home
General Information
UPDATEFederal Provider Number
155026
Provider Name
GREENWOOD VILLAGE SOUTH
Provider Address
295 VILLAGE LANE
GREENWOOD, IN 46143
GREENWOOD, IN 46143
Provider Phone Number
(317) 859-4444
Provider SSA County
400
Provider County Name
Johnson
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
137
Number of Residents in Certified Beds
110
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WESTMINSTER VILLAGE GREENWOOD, INC
Date First Approved to Provide Medicare and Medicaid services
1969-08-05
Continuing Care Retirement Community
Y
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
4
Health Inspection Rating Footnote
QM Rating
3
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
2.09773
Reported LPN Staffing Hours per Resident per Day
1.02273
Reported RN Staffing Hours per Resident per Day
1.14091
Reported Licensed Staffing Hours per Resident per Day
2.16364
Reported Total Nurse Staffing Hours per Resident per Day
4.26137
Reported Physical Therapist Staffing Hours per Resident Per Day
0.12864
Expected CNA Staffing Hours per Resident per Day
2.68790
Expected LPN Staffing Hours per Resident per Day
0.66492
Expected RN Staffing Hours per Resident per Day
1.05405
Expected Total Nurse Staffing Hours per Resident per Day
4.40687
Adjusted CNA Staffing Hours per Resident per Day
1.91495
Adjusted LPN Staffing Hours per Resident per Day
1.27664
Adjusted RN Staffing Hours per Resident per Day
0.80877
Adjusted Total Nurse Staffing Hours per Resident per Day
3.89781
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-03-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-02-08
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
4
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2011-12-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
24.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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