Maple Park Village - Westfield Nursing Home

General Information

UPDATE
Federal Provider Number
155199
Provider Name
MAPLE PARK VILLAGE
Provider Address
776 N UNION ST
WESTFIELD, IN 46074
Provider Phone Number
3178962515
Provider SSA County
280
Provider County Name
Hamilton
Ownership Type
Government - City/county
Number of Certified Beds
106
Number of Residents in Certified Beds
102
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
THE HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY
Date First Approved to Provide Medicare and Medicaid services
1983-07-27
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
5
QM Rating Footnote
Staffing Rating
3
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
2.51078
Reported LPN Staffing Hours per Resident per Day
0.58333
Reported RN Staffing Hours per Resident per Day
1.10735
Reported Licensed Staffing Hours per Resident per Day
1.69069
Reported Total Nurse Staffing Hours per Resident per Day
4.20146
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09510
Expected CNA Staffing Hours per Resident per Day
2.92580
Expected LPN Staffing Hours per Resident per Day
0.81145
Expected RN Staffing Hours per Resident per Day
1.24603
Expected Total Nurse Staffing Hours per Resident per Day
4.98328
Adjusted CNA Staffing Hours per Resident per Day
2.10564
Adjusted LPN Staffing Hours per Resident per Day
0.59667
Adjusted RN Staffing Hours per Resident per Day
0.66404
Adjusted Total Nurse Staffing Hours per Resident per Day
3.39849
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
20
Cycle 1 Standard Survey Health Date
2015-04-13
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-04-25
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2013-05-14
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
12.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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