Providence Gallatin - Warsaw Nursing Home
General Information
UPDATEFederal Provider Number
185360
Provider Name
PROVIDENCE GALLATIN
Provider Address
499 CENTER STREET
WARSAW, KY 41095
WARSAW, KY 41095
Provider Phone Number
8595674548
Provider SSA County
362
Provider County Name
Gallatin
Ownership Type
For profit - Corporation
Number of Certified Beds
120
Number of Residents in Certified Beds
103
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PROVIDENCE HEALTHCARE OF GALLATIN LLC
Date First Approved to Provide Medicare and Medicaid services
1992-09-04
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
4
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
1
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.85874
Reported LPN Staffing Hours per Resident per Day
1.34126
Reported RN Staffing Hours per Resident per Day
0.44951
Reported Licensed Staffing Hours per Resident per Day
1.79078
Reported Total Nurse Staffing Hours per Resident per Day
3.64951
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01019
Expected CNA Staffing Hours per Resident per Day
2.44526
Expected LPN Staffing Hours per Resident per Day
0.75291
Expected RN Staffing Hours per Resident per Day
1.19246
Expected Total Nurse Staffing Hours per Resident per Day
4.39063
Adjusted CNA Staffing Hours per Resident per Day
1.86516
Adjusted LPN Staffing Hours per Resident per Day
1.47859
Adjusted RN Staffing Hours per Resident per Day
0.28167
Adjusted Total Nurse Staffing Hours per Resident per Day
3.35050
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2014-12-11
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
3
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2013-10-03
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
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2012-10-04
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
14.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
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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