Morristown Manor - Morristown Nursing Home

General Information

UPDATE
Federal Provider Number
155691
Provider Name
MORRISTOWN MANOR
Provider Address
868 S WASHINGTON ST
MORRISTOWN, IN 46161
Provider Phone Number
7657636012
Provider SSA County
720
Provider County Name
Shelby
Ownership Type
Government - County
Number of Certified Beds
119
Number of Residents in Certified Beds
100
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
RIVERVIEW HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
2001-08-01
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
3
QM Rating Footnote
Staffing Rating
4
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
2.43000
Reported LPN Staffing Hours per Resident per Day
1.00600
Reported RN Staffing Hours per Resident per Day
0.78400
Reported Licensed Staffing Hours per Resident per Day
1.79000
Reported Total Nurse Staffing Hours per Resident per Day
4.22000
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07000
Expected CNA Staffing Hours per Resident per Day
2.38338
Expected LPN Staffing Hours per Resident per Day
0.64320
Expected RN Staffing Hours per Resident per Day
1.02492
Expected Total Nurse Staffing Hours per Resident per Day
4.05149
Adjusted CNA Staffing Hours per Resident per Day
2.50170
Adjusted LPN Staffing Hours per Resident per Day
1.29817
Adjusted RN Staffing Hours per Resident per Day
0.57156
Adjusted Total Nurse Staffing Hours per Resident per Day
4.19855
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
8
Cycle 1 Standard Survey Health Date
2014-11-25
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
8
Cycle 2 Total Number of Health Deficiencies
1
Cycle 2 Number of Standard Health Deficiencies
1
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
4
Cycle 2 Standard Health Survey Date
2013-10-29
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
56
Cycle 3 Standard Health Survey Date
2012-08-01
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
56
Total Weighted Health Survey Score
14.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
3
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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