Indiana Masonic Home Health Center - Franklin Nursing Home
General Information
UPDATEFederal Provider Number
155593
Provider Name
INDIANA MASONIC HOME HEALTH CENTER
Provider Address
690 S STATE ST
FRANKLIN, IN 46131
FRANKLIN, IN 46131
Provider Phone Number
(317) 736-6141
Provider SSA County
400
Provider County Name
Johnson
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
173
Number of Residents in Certified Beds
115
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
INDIANA MASONIC HOME, INC.
Date First Approved to Provide Medicare and Medicaid services
1996-01-10
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
5
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
2
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
3.23000
Reported LPN Staffing Hours per Resident per Day
1.66435
Reported RN Staffing Hours per Resident per Day
1.14261
Reported Licensed Staffing Hours per Resident per Day
2.80696
Reported Total Nurse Staffing Hours per Resident per Day
6.03696
Reported Physical Therapist Staffing Hours per Resident Per Day
0.03913
Expected CNA Staffing Hours per Resident per Day
2.54457
Expected LPN Staffing Hours per Resident per Day
0.63086
Expected RN Staffing Hours per Resident per Day
0.99963
Expected Total Nurse Staffing Hours per Resident per Day
4.17507
Adjusted CNA Staffing Hours per Resident per Day
3.11465
Adjusted LPN Staffing Hours per Resident per Day
2.18971
Adjusted RN Staffing Hours per Resident per Day
0.85408
Adjusted Total Nurse Staffing Hours per Resident per Day
5.82850
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
32
Cycle 1 Standard Survey Health Date
2015-01-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
32
Cycle 2 Total Number of Health Deficiencies
7
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
24
Cycle 2 Standard Health Survey Date
2013-12-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
24
Cycle 3 Total Number of Health Deficiencies
6
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
28
Cycle 3 Standard Health Survey Date
2012-10-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
28.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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