Todd Dickey Nursing And Rehabilitation Center - Leavenworth Nursing Home
General Information
UPDATEFederal Provider Number
155368
Provider Name
TODD DICKEY NURSING AND REHABILITATION CENTER
Provider Address
712 W 2ND ST
LEAVENWORTH, IN 47137
LEAVENWORTH, IN 47137
Provider Phone Number
8127392292
Provider SSA County
120
Provider County Name
Crawford
Ownership Type
For profit - Corporation
Number of Certified Beds
62
Number of Residents in Certified Beds
51
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
DEARBORN COUNTY HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1990-10-26
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
3
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
3
Staffing Rating Footnote
RN Staffing Rating
4
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
2.23529
Reported LPN Staffing Hours per Resident per Day
0.61667
Reported RN Staffing Hours per Resident per Day
0.86275
Reported Licensed Staffing Hours per Resident per Day
1.47941
Reported Total Nurse Staffing Hours per Resident per Day
3.71471
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11176
Expected CNA Staffing Hours per Resident per Day
2.47261
Expected LPN Staffing Hours per Resident per Day
0.73325
Expected RN Staffing Hours per Resident per Day
1.24673
Expected Total Nurse Staffing Hours per Resident per Day
4.45260
Adjusted CNA Staffing Hours per Resident per Day
2.21820
Adjusted LPN Staffing Hours per Resident per Day
0.69803
Adjusted RN Staffing Hours per Resident per Day
0.51707
Adjusted Total Nurse Staffing Hours per Resident per Day
3.36290
Cycle 1 Total Number of Health Deficiencies
9
Cycle 1 Number of Standard Health Deficiencies
9
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
56
Cycle 1 Standard Survey Health Date
2014-10-20
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
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
20
Cycle 2 Standard Health Survey Date
2013-08-29
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
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
28
Cycle 3 Standard Health Survey Date
2012-07-13
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
28
Total Weighted Health Survey Score
39.33300
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
1365
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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