Indiana Nursing Homes >> Vincennes Nursing Homes >> Willow Manor

Willow Manor - Vincennes Nursing Home

General Information

UPDATE
Federal Provider Number
155042
Provider Name
WILLOW MANOR
Provider Address
3801 OLD BRUCEVILLE RD BOX 136
VINCENNES, IN 47591
Provider Phone Number
(812) 882-1783
Provider SSA County
410
Provider County Name
Knox
Provider Website
Provider Description
Ownership Type
Non profit - Other
Number of Certified Beds
170
Number of Residents in Certified Beds
137
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
ADAMS COUNTY MEMORIAL HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
1967-02-28
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
1
Overall Rating Footnote
Health Inspection Rating
1
Health Inspection Rating Footnote
QM Rating
1
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.74526
Reported LPN Staffing Hours per Resident per Day
0.61095
Reported RN Staffing Hours per Resident per Day
0.79562
Reported Licensed Staffing Hours per Resident per Day
1.40657
Reported Total Nurse Staffing Hours per Resident per Day
3.15183
Reported Physical Therapist Staffing Hours per Resident Per Day
0.05000
Expected CNA Staffing Hours per Resident per Day
2.28033
Expected LPN Staffing Hours per Resident per Day
0.63476
Expected RN Staffing Hours per Resident per Day
1.23411
Expected Total Nurse Staffing Hours per Resident per Day
4.14921
Adjusted CNA Staffing Hours per Resident per Day
1.87795
Adjusted LPN Staffing Hours per Resident per Day
0.79887
Adjusted RN Staffing Hours per Resident per Day
0.48171
Adjusted Total Nurse Staffing Hours per Resident per Day
3.06196
Cycle 1 Total Number of Health Deficiencies
11
Cycle 1 Number of Standard Health Deficiencies
6
Cycle 1 Number of Complaint Health Deficiencies
5
Cycle 1 Health Deficiency Score
80
Cycle 1 Standard Survey Health Date
2014-05-14
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
80
Cycle 2 Total Number of Health Deficiencies
12
Cycle 2 Number of Standard Health Deficiencies
12
Cycle 2 Number of Complaint Health Deficiencies
4
Cycle 2 Health Deficiency Score
80
Cycle 2 Standard Health Survey Date
2013-03-12
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
80
Cycle 3 Total Number of Health Deficiencies
15
Cycle 3 Number of Standard Health Deficiencies
11
Cycle 3 Number of Complaint Health Deficiencies
4
Cycle 3 Health Deficiency Score
104
Cycle 3 Standard Health Survey Date
2012-01-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
104
Total Weighted Health Survey Score
84.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
11
Number of Fines
2
Total Amount of Fines in Dollars
7540
Number of Payment Denials
0
Total Number of Penalties
2
Location
Processing Date
2015-06-01
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