Willow Crossing Health & Rehabilitation Center - Columbus Nursing Home
General Information
UPDATEFederal Provider Number
155535
Provider Name
WILLOW CROSSING HEALTH & REHABILITATION CENTER
Provider Address
3550 CENTRAL AVE
COLUMBUS, IN 47203
COLUMBUS, IN 47203
Provider Phone Number
(812) 379-9669
Provider SSA County
20
Provider County Name
Bartholomew
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
80
Number of Residents in Certified Beds
54
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
WITHAM MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1994-06-30
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
3
Health Inspection Rating Footnote
QM Rating
1
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
2.29537
Reported LPN Staffing Hours per Resident per Day
0.87222
Reported RN Staffing Hours per Resident per Day
0.94074
Reported Licensed Staffing Hours per Resident per Day
1.81296
Reported Total Nurse Staffing Hours per Resident per Day
4.10833
Reported Physical Therapist Staffing Hours per Resident Per Day
0.10741
Expected CNA Staffing Hours per Resident per Day
2.42030
Expected LPN Staffing Hours per Resident per Day
0.70122
Expected RN Staffing Hours per Resident per Day
1.26314
Expected Total Nurse Staffing Hours per Resident per Day
4.38466
Adjusted CNA Staffing Hours per Resident per Day
2.32704
Adjusted LPN Staffing Hours per Resident per Day
1.03240
Adjusted RN Staffing Hours per Resident per Day
0.55649
Adjusted Total Nurse Staffing Hours per Resident per Day
3.77686
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
3
Cycle 1 Health Deficiency Score
60
Cycle 1 Standard Survey Health Date
2015-04-27
Cycle 1 Number of Health Revisits
0
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
60
Cycle 2 Total Number of Health Deficiencies
3
Cycle 2 Number of Standard Health Deficiencies
2
Cycle 2 Number of Complaint Health Deficiencies
1
Cycle 2 Health Deficiency Score
12
Cycle 2 Standard Health Survey Date
2014-03-11
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
12
Cycle 3 Total Number of Health Deficiencies
11
Cycle 3 Number of Standard Health Deficiencies
5
Cycle 3 Number of Complaint Health Deficiencies
6
Cycle 3 Health Deficiency Score
60
Cycle 3 Standard Health Survey Date
2013-01-11
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
60
Total Weighted Health Survey Score
44.00000
Number of Facility Reported Incidents
2
Number of Substantiated Complaints
13
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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