Mulberry Health & Rehabilitation Center - Mulberry Nursing Home
General Information
UPDATEFederal Provider Number
155600
Provider Name
MULBERRY HEALTH & REHABILITATION CENTER
Provider Address
502 W JACKSON ST
MULBERRY, IN 46058
MULBERRY, IN 46058
Provider Phone Number
(765) 296-2911
Provider SSA County
110
Provider County Name
Clinton
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
149
Number of Residents in Certified Beds
134
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HENRY COUNTY MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1996-07-12
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
3
Health Inspection Rating Footnote
QM Rating
3
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
2.14925
Reported LPN Staffing Hours per Resident per Day
0.77799
Reported RN Staffing Hours per Resident per Day
0.88433
Reported Licensed Staffing Hours per Resident per Day
1.66231
Reported Total Nurse Staffing Hours per Resident per Day
3.81157
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09813
Expected CNA Staffing Hours per Resident per Day
2.47019
Expected LPN Staffing Hours per Resident per Day
0.68875
Expected RN Staffing Hours per Resident per Day
1.14194
Expected Total Nurse Staffing Hours per Resident per Day
4.30089
Adjusted CNA Staffing Hours per Resident per Day
2.13490
Adjusted LPN Staffing Hours per Resident per Day
0.93754
Adjusted RN Staffing Hours per Resident per Day
0.57864
Adjusted Total Nurse Staffing Hours per Resident per Day
3.57230
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2015-03-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
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
0
Cycle 2 Standard Health Survey Date
2014-02-21
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
1
Cycle 3 Number of Standard Health Deficiencies
1
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
4
Cycle 3 Standard Health Survey Date
2012-12-18
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
4
Total Weighted Health Survey Score
32.66700
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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