Miller's Merry Manor - Warsaw Nursing Home
General Information
UPDATEFederal Provider Number
155049
Provider Name
MILLER'S MERRY MANOR
Provider Address
1630 S COUNTY FARM RD
WARSAW, IN 46580
WARSAW, IN 46580
Provider Phone Number
(574) 267-8196
Provider SSA County
420
Provider County Name
Kosciusko
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
137
Number of Residents in Certified Beds
87
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
1967-12-12
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
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
3
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
1.99483
Reported LPN Staffing Hours per Resident per Day
0.89540
Reported RN Staffing Hours per Resident per Day
1.06379
Reported Licensed Staffing Hours per Resident per Day
1.95920
Reported Total Nurse Staffing Hours per Resident per Day
3.95402
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01667
Expected CNA Staffing Hours per Resident per Day
2.66021
Expected LPN Staffing Hours per Resident per Day
0.72211
Expected RN Staffing Hours per Resident per Day
1.07449
Expected Total Nurse Staffing Hours per Resident per Day
4.45681
Adjusted CNA Staffing Hours per Resident per Day
1.83997
Adjusted LPN Staffing Hours per Resident per Day
1.02918
Adjusted RN Staffing Hours per Resident per Day
0.73976
Adjusted Total Nurse Staffing Hours per Resident per Day
3.57616
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
28
Cycle 1 Standard Survey Health Date
2015-01-12
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
28
Cycle 2 Total Number of Health Deficiencies
2
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
8
Cycle 2 Standard Health Survey Date
2013-12-18
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
8
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
2012-11-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
16
Total Weighted Health Survey Score
19.33300
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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