Indian Rock Village Health Center - Fairfield Bay Nursing Home
General Information
UPDATEFederal Provider Number
45153
Provider Name
INDIAN ROCK VILLAGE HEALTH CENTER
Provider Address
265 DAVE CREEK PARKWAY
FAIRFIELD BAY, AR 72088
FAIRFIELD BAY, AR 72088
Provider Phone Number
(501) 884-3210
Provider SSA County
700
Provider County Name
Van Buren
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
55
Number of Residents in Certified Beds
41
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
INDIAN ROCK VILLAGE, LLC
Date First Approved to Provide Medicare and Medicaid services
1990-03-27
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
3
Health Inspection Rating Footnote
QM Rating
2
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
3.44390
Reported LPN Staffing Hours per Resident per Day
1.33780
Reported RN Staffing Hours per Resident per Day
0.82683
Reported Licensed Staffing Hours per Resident per Day
2.16463
Reported Total Nurse Staffing Hours per Resident per Day
5.60853
Reported Physical Therapist Staffing Hours per Resident Per Day
0.13902
Expected CNA Staffing Hours per Resident per Day
2.35009
Expected LPN Staffing Hours per Resident per Day
0.63445
Expected RN Staffing Hours per Resident per Day
1.00858
Expected Total Nurse Staffing Hours per Resident per Day
3.99312
Adjusted CNA Staffing Hours per Resident per Day
3.59573
Adjusted LPN Staffing Hours per Resident per Day
1.75014
Adjusted RN Staffing Hours per Resident per Day
0.61255
Adjusted Total Nurse Staffing Hours per Resident per Day
5.66159
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2014-04-18
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
80
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-07-12
Cycle 2 Number of Health Revisits
2
Cycle 2 Health Revisit Score
8
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-06-13
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
6
Cycle 3 Total Health Score
18
Total Weighted Health Survey Score
51.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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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