St Mary Healthcare Center - Lafayette Nursing Home
General Information
UPDATEFederal Provider Number
155094
Provider Name
ST MARY HEALTHCARE CENTER
Provider Address
2201 CASON ST
LAFAYETTE, IN 47904
LAFAYETTE, IN 47904
Provider Phone Number
(765) 447-4102
Provider SSA County
780
Provider County Name
Tippecanoe
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
79
Number of Residents in Certified Beds
67
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WITHAM MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1969-05-26
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
3
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
1
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
1.53507
Reported LPN Staffing Hours per Resident per Day
0.86045
Reported RN Staffing Hours per Resident per Day
1.33806
Reported Licensed Staffing Hours per Resident per Day
2.19851
Reported Total Nurse Staffing Hours per Resident per Day
3.73358
Reported Physical Therapist Staffing Hours per Resident Per Day
0.08134
Expected CNA Staffing Hours per Resident per Day
2.50806
Expected LPN Staffing Hours per Resident per Day
0.66195
Expected RN Staffing Hours per Resident per Day
1.10299
Expected Total Nurse Staffing Hours per Resident per Day
4.27300
Adjusted CNA Staffing Hours per Resident per Day
1.50180
Adjusted LPN Staffing Hours per Resident per Day
1.07890
Adjusted RN Staffing Hours per Resident per Day
0.90644
Adjusted Total Nurse Staffing Hours per Resident per Day
3.52204
Cycle 1 Total Number of Health Deficiencies
3
Cycle 1 Number of Standard Health Deficiencies
3
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-10-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
12
Cycle 2 Total Number of Health Deficiencies
8
Cycle 2 Number of Standard Health Deficiencies
8
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
56
Cycle 2 Standard Health Survey Date
2013-08-23
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
56
Cycle 3 Total Number of Health Deficiencies
2
Cycle 3 Number of Standard Health Deficiencies
2
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
8
Cycle 3 Standard Health Survey Date
2012-07-12
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
8
Total Weighted Health Survey Score
26.00000
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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