Indiana Veterans Home - West Lafayette Nursing Home

General Information

UPDATE
Federal Provider Number
155787
Provider Name
INDIANA VETERANS HOME
Provider Address
3851 N RIVER RD
WEST LAFAYETTE, IN 47906
Provider Phone Number
(765) 463-1502
Provider SSA County
780
Provider County Name
Tippecanoe
Ownership Type
Government - State
Number of Certified Beds
197
Number of Residents in Certified Beds
152
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
STATE OF INDIANA AUDITOR OF STATE
Date First Approved to Provide Medicare and Medicaid services
2011-03-04
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
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
3.59211
Reported LPN Staffing Hours per Resident per Day
1.19474
Reported RN Staffing Hours per Resident per Day
0.89803
Reported Licensed Staffing Hours per Resident per Day
2.09276
Reported Total Nurse Staffing Hours per Resident per Day
5.68488
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07270
Expected CNA Staffing Hours per Resident per Day
2.21796
Expected LPN Staffing Hours per Resident per Day
0.59191
Expected RN Staffing Hours per Resident per Day
0.88919
Expected Total Nurse Staffing Hours per Resident per Day
3.69906
Adjusted CNA Staffing Hours per Resident per Day
3.97391
Adjusted LPN Staffing Hours per Resident per Day
1.67531
Adjusted RN Staffing Hours per Resident per Day
0.75463
Adjusted Total Nurse Staffing Hours per Resident per Day
6.19487
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
4
Cycle 1 Standard Survey Health Date
2015-04-08
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2014-04-17
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
14
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2013-03-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
24.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
7
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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