Hillcrest Village - Jeffersonville Nursing Home
General Information
UPDATEFederal Provider Number
155203
Provider Name
HILLCREST VILLAGE
Provider Address
203 SPARKS AVE
JEFFERSONVILLE, IN 47130
JEFFERSONVILLE, IN 47130
Provider Phone Number
(812) 283-7918
Provider SSA County
90
Provider County Name
Clark
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
149
Number of Residents in Certified Beds
115
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1981-08-14
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
4
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.59130
Reported LPN Staffing Hours per Resident per Day
1.38870
Reported RN Staffing Hours per Resident per Day
1.00826
Reported Licensed Staffing Hours per Resident per Day
2.39696
Reported Total Nurse Staffing Hours per Resident per Day
4.98826
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11261
Expected CNA Staffing Hours per Resident per Day
2.88397
Expected LPN Staffing Hours per Resident per Day
0.85677
Expected RN Staffing Hours per Resident per Day
1.46808
Expected Total Nurse Staffing Hours per Resident per Day
5.20882
Adjusted CNA Staffing Hours per Resident per Day
2.20470
Adjusted LPN Staffing Hours per Resident per Day
1.34531
Adjusted RN Staffing Hours per Resident per Day
0.51317
Adjusted Total Nurse Staffing Hours per Resident per Day
3.86022
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2015-03-20
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2014-04-01
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
27
Cycle 3 Number of Standard Health Deficiencies
6
Cycle 3 Number of Complaint Health Deficiencies
21
Cycle 3 Health Deficiency Score
132
Cycle 3 Standard Health Survey Date
2013-01-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
132
Total Weighted Health Survey Score
38.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
15
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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