Monticello Healthcare - Monticello Nursing Home
General Information
UPDATEFederal Provider Number
155152
Provider Name
MONTICELLO HEALTHCARE
Provider Address
1120 N MAIN ST
MONTICELLO, IN 47960
MONTICELLO, IN 47960
Provider Phone Number
(574) 583-7073
Provider SSA County
900
Provider County Name
White
Provider Website
Provider Description
Ownership Type
Government - City/county
Number of Certified Beds
116
Number of Residents in Certified Beds
95
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
1973-10-17
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.15526
Reported LPN Staffing Hours per Resident per Day
0.80316
Reported RN Staffing Hours per Resident per Day
0.69158
Reported Licensed Staffing Hours per Resident per Day
1.49474
Reported Total Nurse Staffing Hours per Resident per Day
3.65000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.06000
Expected CNA Staffing Hours per Resident per Day
2.83940
Expected LPN Staffing Hours per Resident per Day
0.77672
Expected RN Staffing Hours per Resident per Day
1.26815
Expected Total Nurse Staffing Hours per Resident per Day
4.88427
Adjusted CNA Staffing Hours per Resident per Day
1.86249
Adjusted LPN Staffing Hours per Resident per Day
0.85825
Adjusted RN Staffing Hours per Resident per Day
0.40748
Adjusted Total Nurse Staffing Hours per Resident per Day
3.01228
Cycle 1 Total Number of Health Deficiencies
12
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2015-03-31
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
7
Cycle 2 Number of Complaint Health Deficiencies
6
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2014-05-02
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
68
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
44
Cycle 3 Standard Health Survey Date
2013-02-22
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
44
Total Weighted Health Survey Score
68.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
11
Number of Fines
1
Total Amount of Fines in Dollars
1463
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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