Villas Of Guerin Woods - Georgetown Nursing Home
General Information
UPDATEFederal Provider Number
155770
Provider Name
VILLAS OF GUERIN WOODS
Provider Address
1002 SISTER BARBARA WAY
GEORGETOWN, IN 47122
GEORGETOWN, IN 47122
Provider Phone Number
(812) 951-1878
Provider SSA County
210
Provider County Name
Floyd
Provider Website
Provider Description
Ownership Type
Non profit - Corporation
Number of Certified Beds
50
Number of Residents in Certified Beds
49
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
PROVIDENCE SELF SUFFICIENCY MINISTRIES, INC.
Date First Approved to Provide Medicare and Medicaid services
2008-09-25
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
5
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
4
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
2.97755
Reported LPN Staffing Hours per Resident per Day
1.05204
Reported RN Staffing Hours per Resident per Day
0.83980
Reported Licensed Staffing Hours per Resident per Day
1.89184
Reported Total Nurse Staffing Hours per Resident per Day
4.86939
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11633
Expected CNA Staffing Hours per Resident per Day
2.24709
Expected LPN Staffing Hours per Resident per Day
0.61954
Expected RN Staffing Hours per Resident per Day
0.99254
Expected Total Nurse Staffing Hours per Resident per Day
3.85917
Adjusted CNA Staffing Hours per Resident per Day
3.25133
Adjusted LPN Staffing Hours per Resident per Day
1.40943
Adjusted RN Staffing Hours per Resident per Day
0.63221
Adjusted Total Nurse Staffing Hours per Resident per Day
5.08608
Cycle 1 Total Number of Health Deficiencies
4
Cycle 1 Number of Standard Health Deficiencies
4
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
20
Cycle 1 Standard Survey Health Date
2015-04-21
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
20
Cycle 2 Total Number of Health Deficiencies
0
Cycle 2 Number of Standard Health Deficiencies
0
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
0
Cycle 2 Standard Health Survey Date
2014-04-09
Cycle 2 Number of Health Revisits
0
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2013-02-12
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
10.00000
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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