Hickory Creek At Franklin - Franklin Nursing Home
General Information
UPDATEFederal Provider Number
155442
Provider Name
HICKORY CREEK AT FRANKLIN
Provider Address
580 LEMLEY ST
FRANKLIN, IN 46131
FRANKLIN, IN 46131
Provider Phone Number
(317) 736-8214
Provider SSA County
400
Provider County Name
Johnson
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
36
Number of Residents in Certified Beds
32
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HENRY COUNTY MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1992-05-01
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
3
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
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
1.81406
Reported LPN Staffing Hours per Resident per Day
0.35313
Reported RN Staffing Hours per Resident per Day
1.09531
Reported Licensed Staffing Hours per Resident per Day
1.44844
Reported Total Nurse Staffing Hours per Resident per Day
3.26250
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02031
Expected CNA Staffing Hours per Resident per Day
2.30991
Expected LPN Staffing Hours per Resident per Day
0.70643
Expected RN Staffing Hours per Resident per Day
1.09165
Expected Total Nurse Staffing Hours per Resident per Day
4.10798
Adjusted CNA Staffing Hours per Resident per Day
1.92699
Adjusted LPN Staffing Hours per Resident per Day
0.41490
Adjusted RN Staffing Hours per Resident per Day
0.74971
Adjusted Total Nurse Staffing Hours per Resident per Day
3.20128
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
24
Cycle 1 Standard Survey Health Date
2014-08-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
24
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-06-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-06-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
17.33300
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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