West River Health Campus - Evansville Nursing Home
General Information
UPDATEFederal Provider Number
155785
Provider Name
WEST RIVER HEALTH CAMPUS
Provider Address
714 S EICKHOFF RD
EVANSVILLE, IN 47712
EVANSVILLE, IN 47712
Provider Phone Number
(812) 985-9878
Provider SSA County
810
Provider County Name
Vanderburgh
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
61
Number of Residents in Certified Beds
61
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
2011-02-07
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
2
Health Inspection Rating Footnote
QM Rating
2
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
3.54918
Reported LPN Staffing Hours per Resident per Day
1.52787
Reported RN Staffing Hours per Resident per Day
0.96311
Reported Licensed Staffing Hours per Resident per Day
2.49098
Reported Total Nurse Staffing Hours per Resident per Day
6.04016
Reported Physical Therapist Staffing Hours per Resident Per Day
0.01066
Expected CNA Staffing Hours per Resident per Day
2.66978
Expected LPN Staffing Hours per Resident per Day
0.65548
Expected RN Staffing Hours per Resident per Day
1.02526
Expected Total Nurse Staffing Hours per Resident per Day
4.35052
Adjusted CNA Staffing Hours per Resident per Day
3.26193
Adjusted LPN Staffing Hours per Resident per Day
1.93468
Adjusted RN Staffing Hours per Resident per Day
0.70190
Adjusted Total Nurse Staffing Hours per Resident per Day
5.59641
Cycle 1 Total Number of Health Deficiencies
7
Cycle 1 Number of Standard Health Deficiencies
7
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
52
Cycle 1 Standard Survey Health Date
2014-06-04
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
52
Cycle 2 Total Number of Health Deficiencies
14
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
68
Cycle 2 Standard Health Survey Date
2013-03-22
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
68
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
4
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
16
Cycle 3 Standard Health Survey Date
2012-01-04
Cycle 3 Number of Health Revisits
2
Cycle 3 Health Revisit Score
8
Cycle 3 Total Health Score
24
Total Weighted Health Survey Score
52.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
7963
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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