Providence Health Care Center - Saint Mary Of The Wo Nursing Home

General Information

UPDATE
Federal Provider Number
155802
Provider Name
PROVIDENCE HEALTH CARE CENTER
Provider Address
1 SISTERS OF PROVIDENCE
SAINT MARY OF THE WO, IN 47876
Provider Phone Number
(812) 535-1050
Provider SSA County
830
Provider County Name
Vigo
Provider Website
Provider Description
Ownership Type
Government - County
Number of Certified Beds
70
Number of Residents in Certified Beds
65
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PUTNAM COUNTY HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
2012-10-17
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Both
Automatic Sprinkler Systems in All Required Areas
Yes

Rating Detail Information

Overall Rating
5
Overall Rating Footnote
Health Inspection Rating
5
Health Inspection Rating Footnote
QM Rating
5
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
2.77692
Reported LPN Staffing Hours per Resident per Day
1.11154
Reported RN Staffing Hours per Resident per Day
1.25692
Reported Licensed Staffing Hours per Resident per Day
2.36846
Reported Total Nurse Staffing Hours per Resident per Day
5.14538
Reported Physical Therapist Staffing Hours per Resident Per Day
0.15308
Expected CNA Staffing Hours per Resident per Day
2.45193
Expected LPN Staffing Hours per Resident per Day
0.65542
Expected RN Staffing Hours per Resident per Day
1.16348
Expected Total Nurse Staffing Hours per Resident per Day
4.27083
Adjusted CNA Staffing Hours per Resident per Day
2.77892
Adjusted LPN Staffing Hours per Resident per Day
1.40762
Adjusted RN Staffing Hours per Resident per Day
0.80721
Adjusted Total Nurse Staffing Hours per Resident per Day
4.85632
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
4
Cycle 1 Standard Survey Health Date
2015-01-26
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
4
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
2013-11-04
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
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
8
Cycle 3 Standard Health Survey Date
2012-08-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
7.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
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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