Randolph Nursing Home - Winchester Nursing Home
General Information
UPDATEFederal Provider Number
155231
Provider Name
RANDOLPH NURSING HOME
Provider Address
701 S OAK ST
WINCHESTER, IN 47394
WINCHESTER, IN 47394
Provider Phone Number
(765) 584-2201
Provider SSA County
670
Provider County Name
Randolph
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
94
Number of Residents in Certified Beds
76
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
HOOSIER CARE II INC
Date First Approved to Provide Medicare and Medicaid services
1984-04-06
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
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
2
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
1.82303
Reported LPN Staffing Hours per Resident per Day
0.83158
Reported RN Staffing Hours per Resident per Day
0.69145
Reported Licensed Staffing Hours per Resident per Day
1.52303
Reported Total Nurse Staffing Hours per Resident per Day
3.34606
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07500
Expected CNA Staffing Hours per Resident per Day
2.61435
Expected LPN Staffing Hours per Resident per Day
0.67973
Expected RN Staffing Hours per Resident per Day
1.15158
Expected Total Nurse Staffing Hours per Resident per Day
4.44566
Adjusted CNA Staffing Hours per Resident per Day
1.71101
Adjusted LPN Staffing Hours per Resident per Day
1.01541
Adjusted RN Staffing Hours per Resident per Day
0.44865
Adjusted Total Nurse Staffing Hours per Resident per Day
3.03389
Cycle 1 Total Number of Health Deficiencies
13
Cycle 1 Number of Standard Health Deficiencies
11
Cycle 1 Number of Complaint Health Deficiencies
2
Cycle 1 Health Deficiency Score
64
Cycle 1 Standard Survey Health Date
2014-11-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
64
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
16
Cycle 2 Standard Health Survey Date
2013-09-04
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
16
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
3
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-06-15
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
44.00000
Number of Facility Reported Incidents
1
Number of Substantiated Complaints
2
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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