Prairie Lakes Health Campus - Noblesville Nursing Home
General Information
UPDATEFederal Provider Number
155779
Provider Name
PRAIRIE LAKES HEALTH CAMPUS
Provider Address
9730 PRAIRIE LAKES BLVD E
NOBLESVILLE, IN 46060
NOBLESVILLE, IN 46060
Provider Phone Number
(317) 770-3644
Provider SSA County
280
Provider County Name
Hamilton
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
61
Number of Residents in Certified Beds
52
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HANCOCK REGIONAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
2010-06-22
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
5
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
2.25673
Reported LPN Staffing Hours per Resident per Day
1.64423
Reported RN Staffing Hours per Resident per Day
1.36250
Reported Licensed Staffing Hours per Resident per Day
3.00673
Reported Total Nurse Staffing Hours per Resident per Day
5.26346
Reported Physical Therapist Staffing Hours per Resident Per Day
0.22019
Expected CNA Staffing Hours per Resident per Day
2.54983
Expected LPN Staffing Hours per Resident per Day
0.64437
Expected RN Staffing Hours per Resident per Day
1.12191
Expected Total Nurse Staffing Hours per Resident per Day
4.31611
Adjusted CNA Staffing Hours per Resident per Day
2.17165
Adjusted LPN Staffing Hours per Resident per Day
2.11789
Adjusted RN Staffing Hours per Resident per Day
0.90744
Adjusted Total Nurse Staffing Hours per Resident per Day
4.91565
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-11-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
7
Cycle 2 Health Deficiency Score
88
Cycle 2 Standard Health Survey Date
2013-11-21
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
88
Cycle 3 Total Number of Health Deficiencies
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
52
Cycle 3 Standard Health Survey Date
2012-09-27
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
52
Total Weighted Health Survey Score
64.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
10
Number of Fines
2
Total Amount of Fines in Dollars
25050
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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