Indiana Nursing Homes >> Peru Nursing Homes >> Hickory Creek At Peru

Hickory Creek At Peru - Peru Nursing Home

General Information

UPDATE
Federal Provider Number
155406
Provider Name
HICKORY CREEK AT PERU
Provider Address
390 W BOULEVARD
PERU, IN 46970
Provider Phone Number
(765) 473-4900
Provider SSA County
510
Provider County Name
Miami
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
36
Number of Residents in Certified Beds
34
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
1991-11-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
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
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
1.89706
Reported LPN Staffing Hours per Resident per Day
0.67647
Reported RN Staffing Hours per Resident per Day
0.66324
Reported Licensed Staffing Hours per Resident per Day
1.33971
Reported Total Nurse Staffing Hours per Resident per Day
3.23677
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03088
Expected CNA Staffing Hours per Resident per Day
2.27715
Expected LPN Staffing Hours per Resident per Day
0.67492
Expected RN Staffing Hours per Resident per Day
1.02327
Expected Total Nurse Staffing Hours per Resident per Day
3.97533
Adjusted CNA Staffing Hours per Resident per Day
2.04415
Adjusted LPN Staffing Hours per Resident per Day
0.83190
Adjusted RN Staffing Hours per Resident per Day
0.48431
Adjusted Total Nurse Staffing Hours per Resident per Day
3.28201
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
1
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2015-02-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2014-02-07
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
8
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
36
Cycle 3 Standard Health Survey Date
2013-03-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
36
Total Weighted Health Survey Score
28.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
4
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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