Homewood Health Campus - Lebanon Nursing Home
General Information
UPDATEFederal Provider Number
155680
Provider Name
HOMEWOOD HEALTH CAMPUS
Provider Address
2494 N LEBANON ST
LEBANON, IN 46052
LEBANON, IN 46052
Provider Phone Number
(765) 482-2076
Provider SSA County
50
Provider County Name
Boone
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
68
Number of Residents in Certified Beds
54
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
TRILOGY HEALTHCARE OF LEBANON, LLC
Date First Approved to Provide Medicare and Medicaid services
2000-10-25
Continuing Care Retirement Community
Y
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
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
5
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
2.96944
Reported LPN Staffing Hours per Resident per Day
1.20833
Reported RN Staffing Hours per Resident per Day
1.55370
Reported Licensed Staffing Hours per Resident per Day
2.76204
Reported Total Nurse Staffing Hours per Resident per Day
5.73147
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11944
Expected CNA Staffing Hours per Resident per Day
2.38267
Expected LPN Staffing Hours per Resident per Day
0.62904
Expected RN Staffing Hours per Resident per Day
1.14837
Expected Total Nurse Staffing Hours per Resident per Day
4.16008
Adjusted CNA Staffing Hours per Resident per Day
3.05796
Adjusted LPN Staffing Hours per Resident per Day
1.59436
Adjusted RN Staffing Hours per Resident per Day
1.01093
Adjusted Total Nurse Staffing Hours per Resident per Day
5.55349
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
40
Cycle 1 Standard Survey Health Date
2014-10-30
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
40
Cycle 2 Total Number of Health Deficiencies
10
Cycle 2 Number of Standard Health Deficiencies
10
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-08-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
52
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
12
Cycle 3 Number of Complaint Health Deficiencies
5
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2012-10-25
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
46.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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