White River Lodge - Bedford Nursing Home
General Information
UPDATEFederal Provider Number
155631
Provider Name
WHITE RIVER LODGE
Provider Address
3710 KENNY SIMPSON LN
BEDFORD, IN 47421
BEDFORD, IN 47421
Provider Phone Number
(812) 275-7006
Provider SSA County
460
Provider County Name
Lawrence
Provider Website
Provider Description
Ownership Type
Government - City/county
Number of Certified Beds
74
Number of Residents in Certified Beds
45
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
RUSH MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1997-08-13
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
3
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
3
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
2.00667
Reported LPN Staffing Hours per Resident per Day
0.82111
Reported RN Staffing Hours per Resident per Day
0.64444
Reported Licensed Staffing Hours per Resident per Day
1.46556
Reported Total Nurse Staffing Hours per Resident per Day
3.47222
Reported Physical Therapist Staffing Hours per Resident Per Day
0.02667
Expected CNA Staffing Hours per Resident per Day
2.46645
Expected LPN Staffing Hours per Resident per Day
0.60961
Expected RN Staffing Hours per Resident per Day
0.90193
Expected Total Nurse Staffing Hours per Resident per Day
3.97798
Adjusted CNA Staffing Hours per Resident per Day
1.99630
Adjusted LPN Staffing Hours per Resident per Day
1.11796
Adjusted RN Staffing Hours per Resident per Day
0.53388
Adjusted Total Nurse Staffing Hours per Resident per Day
3.51841
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
2014-10-31
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
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
36
Cycle 2 Standard Health Survey Date
2013-12-17
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
36
Cycle 3 Total Number of Health Deficiencies
3
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
40
Cycle 3 Standard Health Survey Date
2012-11-08
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
40
Total Weighted Health Survey Score
24.66700
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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