Highland Manor Healthcare - Indianapolis Nursing Home
General Information
UPDATEFederal Provider Number
155711
Provider Name
HIGHLAND MANOR HEALTHCARE
Provider Address
2926 N CAPITOL AVE
INDIANAPOLIS, IN 46208
INDIANAPOLIS, IN 46208
Provider Phone Number
(317) 926-0254
Provider SSA County
480
Provider County Name
Marion
Provider Website
Provider Description
Ownership Type
Government - City/county
Number of Certified Beds
52
Number of Residents in Certified Beds
28
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ADAMS COUNTY MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
2002-10-22
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
None
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
3
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.76250
Reported LPN Staffing Hours per Resident per Day
1.32857
Reported RN Staffing Hours per Resident per Day
0.38929
Reported Licensed Staffing Hours per Resident per Day
1.71786
Reported Total Nurse Staffing Hours per Resident per Day
3.48036
Reported Physical Therapist Staffing Hours per Resident Per Day
0.14464
Expected CNA Staffing Hours per Resident per Day
2.31300
Expected LPN Staffing Hours per Resident per Day
0.57480
Expected RN Staffing Hours per Resident per Day
1.05426
Expected Total Nurse Staffing Hours per Resident per Day
3.94205
Adjusted CNA Staffing Hours per Resident per Day
1.86971
Adjusted LPN Staffing Hours per Resident per Day
1.91844
Adjusted RN Staffing Hours per Resident per Day
0.27591
Adjusted Total Nurse Staffing Hours per Resident per Day
3.55880
Cycle 1 Total Number of Health Deficiencies
15
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
7
Cycle 1 Health Deficiency Score
112
Cycle 1 Standard Survey Health Date
2015-03-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
112
Cycle 2 Total Number of Health Deficiencies
35
Cycle 2 Number of Standard Health Deficiencies
15
Cycle 2 Number of Complaint Health Deficiencies
21
Cycle 2 Health Deficiency Score
156
Cycle 2 Standard Health Survey Date
2014-02-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
156
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
92
Cycle 3 Standard Health Survey Date
2012-11-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
92
Total Weighted Health Survey Score
123.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
21
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
1
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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