Meadowood Health Pavilion - Bloomington Nursing Home
General Information
UPDATEFederal Provider Number
155253
Provider Name
MEADOWOOD HEALTH PAVILION
Provider Address
2455 TAMARACK TR
BLOOMINGTON, IN 47408
BLOOMINGTON, IN 47408
Provider Phone Number
(812) 336-7060
Provider SSA County
520
Provider County Name
Monroe
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
66
Number of Residents in Certified Beds
52
Provider Type
Medicare
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
1985-02-01
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
3
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.37212
Reported LPN Staffing Hours per Resident per Day
1.41250
Reported RN Staffing Hours per Resident per Day
0.53077
Reported Licensed Staffing Hours per Resident per Day
1.94327
Reported Total Nurse Staffing Hours per Resident per Day
4.31539
Reported Physical Therapist Staffing Hours per Resident Per Day
0.22788
Expected CNA Staffing Hours per Resident per Day
2.29157
Expected LPN Staffing Hours per Resident per Day
0.60213
Expected RN Staffing Hours per Resident per Day
1.10458
Expected Total Nurse Staffing Hours per Resident per Day
3.99828
Adjusted CNA Staffing Hours per Resident per Day
2.53995
Adjusted LPN Staffing Hours per Resident per Day
1.94705
Adjusted RN Staffing Hours per Resident per Day
0.35904
Adjusted Total Nurse Staffing Hours per Resident per Day
4.35060
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-07-21
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-08-29
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
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2012-10-09
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
30.00000
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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