Miller's Merry Manor - Plymouth Nursing Home
General Information
UPDATEFederal Provider Number
155102
Provider Name
MILLER'S MERRY MANOR
Provider Address
635 OAKHILL AVE
PLYMOUTH, IN 46563
PLYMOUTH, IN 46563
Provider Phone Number
(574) 936-9981
Provider SSA County
490
Provider County Name
Marshall
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
131
Number of Residents in Certified Beds
84
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
JOHNSON MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1969-10-16
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
4
Overall Rating Footnote
Health Inspection Rating
3
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
2.00536
Reported LPN Staffing Hours per Resident per Day
0.86190
Reported RN Staffing Hours per Resident per Day
0.86607
Reported Licensed Staffing Hours per Resident per Day
1.72798
Reported Total Nurse Staffing Hours per Resident per Day
3.73333
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02798
Expected CNA Staffing Hours per Resident per Day
2.74978
Expected LPN Staffing Hours per Resident per Day
0.67126
Expected RN Staffing Hours per Resident per Day
1.07145
Expected Total Nurse Staffing Hours per Resident per Day
4.49249
Adjusted CNA Staffing Hours per Resident per Day
1.78944
Adjusted LPN Staffing Hours per Resident per Day
1.06572
Adjusted RN Staffing Hours per Resident per Day
0.60397
Adjusted Total Nurse Staffing Hours per Resident per Day
3.34974
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
2014-10-14
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
11
Cycle 2 Number of Standard Health Deficiencies
9
Cycle 2 Number of Complaint Health Deficiencies
5
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2013-08-26
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
56
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
10
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2012-09-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
32.00000
Number of Facility Reported Incidents
0
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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