Indiana Nursing Homes >> Jasper Nursing Homes >> St Charles Health Campus

St Charles Health Campus - Jasper Nursing Home

General Information

UPDATE
Federal Provider Number
155674
Provider Name
ST CHARLES HEALTH CAMPUS
Provider Address
3150 ST CHARLES ST
JASPER, IN 47546
Provider Phone Number
(812) 634-6570
Provider SSA County
180
Provider County Name
Dubois
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
68
Number of Residents in Certified Beds
53
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GOOD SAMARITAN HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
2000-07-31
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
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
4
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
1.48962
Reported LPN Staffing Hours per Resident per Day
1.56698
Reported RN Staffing Hours per Resident per Day
0.75943
Reported Licensed Staffing Hours per Resident per Day
2.32642
Reported Total Nurse Staffing Hours per Resident per Day
3.81603
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09811
Expected CNA Staffing Hours per Resident per Day
2.44796
Expected LPN Staffing Hours per Resident per Day
0.74690
Expected RN Staffing Hours per Resident per Day
1.43645
Expected Total Nurse Staffing Hours per Resident per Day
4.63131
Adjusted CNA Staffing Hours per Resident per Day
1.49311
Adjusted LPN Staffing Hours per Resident per Day
1.74133
Adjusted RN Staffing Hours per Resident per Day
0.39503
Adjusted Total Nurse Staffing Hours per Resident per Day
3.32132
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-11-19
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
6
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
28
Cycle 2 Standard Health Survey Date
2013-09-10
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
7
Cycle 3 Number of Standard Health Deficiencies
7
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
48
Cycle 3 Standard Health Survey Date
2012-08-10
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
48
Total Weighted Health Survey Score
45.33300
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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