Westside Retirement Village - Indianapolis Nursing Home
General Information
UPDATEFederal Provider Number
155606
Provider Name
WESTSIDE RETIREMENT VILLAGE
Provider Address
8616 W 10TH ST
INDIANAPOLIS, IN 46234
INDIANAPOLIS, IN 46234
Provider Phone Number
3172711020
Provider SSA County
480
Provider County Name
Marion
Ownership Type
For profit - Corporation
Number of Certified Beds
132
Number of Residents in Certified Beds
107
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WESTSIDE LIMITED PARTNERSHIP
Date First Approved to Provide Medicare and Medicaid services
1997-01-01
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
2
Overall Rating Footnote
Health Inspection Rating
2
Health Inspection Rating Footnote
QM Rating
5
QM Rating Footnote
Staffing Rating
1
Staffing Rating Footnote
RN Staffing Rating
2
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.86589
Reported LPN Staffing Hours per Resident per Day
1.11075
Reported RN Staffing Hours per Resident per Day
0.47570
Reported Licensed Staffing Hours per Resident per Day
1.58645
Reported Total Nurse Staffing Hours per Resident per Day
3.45234
Reported Physical Therapist Staffing Hours per Resident Per Day
0.37757
Expected CNA Staffing Hours per Resident per Day
2.51618
Expected LPN Staffing Hours per Resident per Day
0.66513
Expected RN Staffing Hours per Resident per Day
1.24417
Expected Total Nurse Staffing Hours per Resident per Day
4.42548
Adjusted CNA Staffing Hours per Resident per Day
1.81956
Adjusted LPN Staffing Hours per Resident per Day
1.38608
Adjusted RN Staffing Hours per Resident per Day
0.28569
Adjusted Total Nurse Staffing Hours per Resident per Day
3.14453
Cycle 1 Total Number of Health Deficiencies
6
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
48
Cycle 1 Standard Survey Health Date
2014-06-19
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
48
Cycle 2 Total Number of Health Deficiencies
11
Cycle 2 Number of Standard Health Deficiencies
11
Cycle 2 Number of Complaint Health Deficiencies
11
Cycle 2 Health Deficiency Score
60
Cycle 2 Standard Health Survey Date
2013-04-04
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
9
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
64
Cycle 3 Standard Health Survey Date
2012-02-07
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
64
Total Weighted Health Survey Score
54.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
20
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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