Heritage House Of Shelbyville - Shelbyville Nursing Home
General Information
UPDATEFederal Provider Number
155022
Provider Name
HERITAGE HOUSE OF SHELBYVILLE
Provider Address
2309 S MILLER ST
SHELBYVILLE, IN 46176
SHELBYVILLE, IN 46176
Provider Phone Number
3173989781
Provider SSA County
720
Provider County Name
Shelby
Ownership Type
Government - City/county
Number of Certified Beds
141
Number of Residents in Certified Beds
79
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MAJOR 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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.11582
Reported LPN Staffing Hours per Resident per Day
1.21582
Reported RN Staffing Hours per Resident per Day
0.52595
Reported Licensed Staffing Hours per Resident per Day
1.74177
Reported Total Nurse Staffing Hours per Resident per Day
3.85759
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08165
Expected CNA Staffing Hours per Resident per Day
2.52538
Expected LPN Staffing Hours per Resident per Day
0.70663
Expected RN Staffing Hours per Resident per Day
1.17448
Expected Total Nurse Staffing Hours per Resident per Day
4.40649
Adjusted CNA Staffing Hours per Resident per Day
2.05577
Adjusted LPN Staffing Hours per Resident per Day
1.42809
Adjusted RN Staffing Hours per Resident per Day
0.33461
Adjusted Total Nurse Staffing Hours per Resident per Day
3.52879
Cycle 1 Total Number of Health Deficiencies
14
Cycle 1 Number of Standard Health Deficiencies
12
Cycle 1 Number of Complaint Health Deficiencies
6
Cycle 1 Health Deficiency Score
84
Cycle 1 Standard Survey Health Date
2014-12-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
84
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
44
Cycle 2 Standard Health Survey Date
2013-11-08
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
13
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
135
Cycle 3 Standard Health Survey Date
2012-09-28
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
135
Total Weighted Health Survey Score
79.16700
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
6
Number of Fines
1
Total Amount of Fines in Dollars
3868
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Especially Kidz Health & Rehab
2325 S Miller St |
SHELBYVILLE IN 46176 | 0.1 mile away
Ashford Place Health Campus
2200 N Riley Hwy |
SHELBYVILLE IN 46176 | 3.8 miles away
Waldron Health And Rehab Center
505 N Main St |
WALDRON IN 46182 | 7.2 miles away
Morristown Manor
868 S Washington St |
MORRISTOWN IN 46161 | 12 miles away
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