Prairie Village Nursing And Rehabilitation Center - Washington Nursing Home
General Information
UPDATEFederal Provider Number
155461
Provider Name
PRAIRIE VILLAGE NURSING AND REHABILITATION CENTER
Provider Address
801 S SR 57
WASHINGTON, IN 47501
WASHINGTON, IN 47501
Provider Phone Number
(812) 254-4516
Provider SSA County
130
Provider County Name
Daviess
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
65
Number of Residents in Certified Beds
60
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
DEARBORN COUNTY HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1992-07-01
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
3
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
3
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
2.08500
Reported LPN Staffing Hours per Resident per Day
0.84667
Reported RN Staffing Hours per Resident per Day
0.71417
Reported Licensed Staffing Hours per Resident per Day
1.56083
Reported Total Nurse Staffing Hours per Resident per Day
3.64584
Reported Physical Therapist Staffing Hours per Resident Per Day
0.24417
Expected CNA Staffing Hours per Resident per Day
2.47666
Expected LPN Staffing Hours per Resident per Day
0.68363
Expected RN Staffing Hours per Resident per Day
1.20840
Expected Total Nurse Staffing Hours per Resident per Day
4.36869
Adjusted CNA Staffing Hours per Resident per Day
2.06567
Adjusted LPN Staffing Hours per Resident per Day
1.02795
Adjusted RN Staffing Hours per Resident per Day
0.44160
Adjusted Total Nurse Staffing Hours per Resident per Day
3.36394
Cycle 1 Total Number of Health Deficiencies
10
Cycle 1 Number of Standard Health Deficiencies
10
Cycle 1 Number of Complaint Health Deficiencies
10
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-03-05
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
12
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
11
Cycle 2 Health Deficiency Score
84
Cycle 2 Standard Health Survey Date
2013-02-26
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
84
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-01-19
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
64.00000
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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