Hillside Manor Nursing Home - Washington Nursing Home
General Information
UPDATEFederal Provider Number
155708
Provider Name
HILLSIDE MANOR NURSING HOME
Provider Address
1109 E NATIONAL HWY
WASHINGTON, IN 47501
WASHINGTON, IN 47501
Provider Phone Number
(812) 254-7159
Provider SSA County
130
Provider County Name
Daviess
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
48
Number of Residents in Certified Beds
43
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MAJOR HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
2002-09-27
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
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
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.49186
Reported LPN Staffing Hours per Resident per Day
0.64419
Reported RN Staffing Hours per Resident per Day
0.46395
Reported Licensed Staffing Hours per Resident per Day
1.10814
Reported Total Nurse Staffing Hours per Resident per Day
2.60000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.00698
Expected CNA Staffing Hours per Resident per Day
2.70117
Expected LPN Staffing Hours per Resident per Day
0.70411
Expected RN Staffing Hours per Resident per Day
1.18711
Expected Total Nurse Staffing Hours per Resident per Day
4.59240
Adjusted CNA Staffing Hours per Resident per Day
1.35518
Adjusted LPN Staffing Hours per Resident per Day
0.75937
Adjusted RN Staffing Hours per Resident per Day
0.29202
Adjusted Total Nurse Staffing Hours per Resident per Day
2.28211
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
52
Cycle 1 Standard Survey Health Date
2014-04-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
18
Cycle 2 Number of Standard Health Deficiencies
17
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
156
Cycle 2 Standard Health Survey Date
2013-04-19
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
15
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
80
Cycle 3 Standard Health Survey Date
2012-02-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
80
Total Weighted Health Survey Score
91.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
8
Number of Fines
3
Total Amount of Fines in Dollars
12253
Number of Payment Denials
0
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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