Richland Bean Blossom Health Care Center - Ellettsville Nursing Home
General Information
UPDATEFederal Provider Number
155523
Provider Name
RICHLAND BEAN BLOSSOM HEALTH CARE CENTER
Provider Address
5911 W SR 46
ELLETTSVILLE, IN 47429
ELLETTSVILLE, IN 47429
Provider Phone Number
(812) 876-6400
Provider SSA County
520
Provider County Name
Monroe
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
79
Number of Residents in Certified Beds
77
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
RICHLAND BEAN BLOSSOM LLC
Date First Approved to Provide Medicare and Medicaid services
1994-06-03
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
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
1.62143
Reported LPN Staffing Hours per Resident per Day
0.52792
Reported RN Staffing Hours per Resident per Day
1.25779
Reported Licensed Staffing Hours per Resident per Day
1.78571
Reported Total Nurse Staffing Hours per Resident per Day
3.40714
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08636
Expected CNA Staffing Hours per Resident per Day
2.26642
Expected LPN Staffing Hours per Resident per Day
0.67035
Expected RN Staffing Hours per Resident per Day
1.30521
Expected Total Nurse Staffing Hours per Resident per Day
4.24198
Adjusted CNA Staffing Hours per Resident per Day
1.75541
Adjusted LPN Staffing Hours per Resident per Day
0.65365
Adjusted RN Staffing Hours per Resident per Day
0.72005
Adjusted Total Nurse Staffing Hours per Resident per Day
3.23760
Cycle 1 Total Number of Health Deficiencies
18
Cycle 1 Number of Standard Health Deficiencies
14
Cycle 1 Number of Complaint Health Deficiencies
4
Cycle 1 Health Deficiency Score
100
Cycle 1 Standard Survey Health Date
2015-05-04
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
100
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2014-03-18
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
28
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
12
Cycle 3 Standard Health Survey Date
2013-03-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
12
Total Weighted Health Survey Score
61.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
5
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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