Wellbrooke Of Crawfordsville - Crawfordsville Nursing Home
General Information
UPDATEFederal Provider Number
155812
Provider Name
WELLBROOKE OF CRAWFORDSVILLE
Provider Address
517 CONCORD ROAD
CRAWFORDSVILLE, IN 47933
CRAWFORDSVILLE, IN 47933
Provider Phone Number
(765) 362-9122
Provider SSA County
530
Provider County Name
Montgomery
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
70
Number of Residents in Certified Beds
42
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
LCS CRAWFORDSVILLE LLC
Date First Approved to Provide Medicare and Medicaid services
2013-11-14
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
5
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
3.53571
Reported LPN Staffing Hours per Resident per Day
2.30595
Reported RN Staffing Hours per Resident per Day
2.61905
Reported Licensed Staffing Hours per Resident per Day
4.92500
Reported Total Nurse Staffing Hours per Resident per Day
8.46071
Reported Physical Therapist Staffing Hours per Resident Per Day
0.30833
Expected CNA Staffing Hours per Resident per Day
2.33663
Expected LPN Staffing Hours per Resident per Day
0.70677
Expected RN Staffing Hours per Resident per Day
1.41337
Expected Total Nurse Staffing Hours per Resident per Day
4.45677
Adjusted CNA Staffing Hours per Resident per Day
3.71286
Adjusted LPN Staffing Hours per Resident per Day
2.70801
Adjusted RN Staffing Hours per Resident per Day
1.38460
Adjusted Total Nurse Staffing Hours per Resident per Day
7.65224
Cycle 1 Total Number of Health Deficiencies
2
Cycle 1 Number of Standard Health Deficiencies
2
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
12
Cycle 1 Standard Survey Health Date
2014-12-09
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
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
2013-11-14
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
0000-00-00
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
7.20000
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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