White Oak Health Campus - Monticello Nursing Home

General Information

UPDATE
Federal Provider Number
155782
Provider Name
WHITE OAK HEALTH CAMPUS
Provider Address
814 S 6TH ST
MONTICELLO, IN 47960
Provider Phone Number
(574) 583-0324
Provider SSA County
900
Provider County Name
White
Ownership Type
Government - County
Number of Certified Beds
61
Number of Residents in Certified Beds
60
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
Legal Business Name Not Available
Date First Approved to Provide Medicare and Medicaid services
2010-09-08
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
2
Health Inspection Rating Footnote
QM Rating
5
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
2.55333
Reported LPN Staffing Hours per Resident per Day
1.10333
Reported RN Staffing Hours per Resident per Day
1.02750
Reported Licensed Staffing Hours per Resident per Day
2.13083
Reported Total Nurse Staffing Hours per Resident per Day
4.68416
Reported Physical Therapist Staffing Hours per Resident Per Day
0.09083
Expected CNA Staffing Hours per Resident per Day
2.59197
Expected LPN Staffing Hours per Resident per Day
0.68627
Expected RN Staffing Hours per Resident per Day
1.12617
Expected Total Nurse Staffing Hours per Resident per Day
4.40440
Adjusted CNA Staffing Hours per Resident per Day
2.41712
Adjusted LPN Staffing Hours per Resident per Day
1.33441
Adjusted RN Staffing Hours per Resident per Day
0.68174
Adjusted Total Nurse Staffing Hours per Resident per Day
4.28693
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2015-02-10
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
9
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
3
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2014-01-28
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
19
Cycle 3 Number of Standard Health Deficiencies
19
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
108
Cycle 3 Standard Health Survey Date
2012-12-21
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
108
Total Weighted Health Survey Score
52.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
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

Nursiong Homes Nearby

Whispering Pines Rehabilitation Centre

410 Tioga Rd | MONTICELLO IN 47960 | 1.1 miles away

Monticello Healthcare

1120 N Main St | MONTICELLO IN 47960 | 2 miles away

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