North Capitol Nursing & Rehabilitation Center - Indianapolis Nursing Home
General Information
UPDATEFederal Provider Number
155226
Provider Name
NORTH CAPITOL NURSING & REHABILITATION CENTER
Provider Address
2010 N CAPITOL AVE
INDIANAPOLIS, IN 46202
INDIANAPOLIS, IN 46202
Provider Phone Number
3179245821
Provider SSA County
480
Provider County Name
Marion
Ownership Type
Government - County
Number of Certified Beds
123
Number of Residents in Certified Beds
117
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
1983-12-02
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
5
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
4
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
2.97222
Reported LPN Staffing Hours per Resident per Day
0.77350
Reported RN Staffing Hours per Resident per Day
1.71709
Reported Licensed Staffing Hours per Resident per Day
2.49060
Reported Total Nurse Staffing Hours per Resident per Day
5.46281
Reported Physical Therapist Staffing Hours per Resident Per Day
0.18675
Expected CNA Staffing Hours per Resident per Day
2.99900
Expected LPN Staffing Hours per Resident per Day
0.88663
Expected RN Staffing Hours per Resident per Day
1.39747
Expected Total Nurse Staffing Hours per Resident per Day
5.28310
Adjusted CNA Staffing Hours per Resident per Day
2.43179
Adjusted LPN Staffing Hours per Resident per Day
0.72409
Adjusted RN Staffing Hours per Resident per Day
0.91809
Adjusted Total Nurse Staffing Hours per Resident per Day
4.16801
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-08-21
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
56
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
2
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-11-05
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
4
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
2
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-08-16
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
44.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
12
Number of Fines
3
Total Amount of Fines in Dollars
19715
Number of Payment Denials
0
Total Number of Penalties
3
Location
Processing Date
2015-06-01
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