Woodmont Health Campus - Boonville Nursing Home

General Information

UPDATE
Federal Provider Number
155682
Provider Name
WOODMONT HEALTH CAMPUS
Provider Address
1325 ROCKPORT RD
BOONVILLE, IN 47601
Provider Phone Number
(812) 897-4114
Provider SSA County
860
Provider County Name
Warrick
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
60
Number of Residents in Certified Beds
51
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
GOOD SAMARITAN HOSPITAL
Date First Approved to Provide Medicare and Medicaid services
2000-11-08
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
Y
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
2
Health Inspection Rating Footnote
QM Rating
3
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
2.85588
Reported LPN Staffing Hours per Resident per Day
1.35098
Reported RN Staffing Hours per Resident per Day
1.05490
Reported Licensed Staffing Hours per Resident per Day
2.40588
Reported Total Nurse Staffing Hours per Resident per Day
5.26176
Reported Physical Therapist Staffing Hours per Resident Per Day
0.15588
Expected CNA Staffing Hours per Resident per Day
2.55118
Expected LPN Staffing Hours per Resident per Day
0.73295
Expected RN Staffing Hours per Resident per Day
1.22417
Expected Total Nurse Staffing Hours per Resident per Day
4.50830
Adjusted CNA Staffing Hours per Resident per Day
2.74676
Adjusted LPN Staffing Hours per Resident per Day
1.52986
Adjusted RN Staffing Hours per Resident per Day
0.64388
Adjusted Total Nurse Staffing Hours per Resident per Day
4.70457
Cycle 1 Total Number of Health Deficiencies
8
Cycle 1 Number of Standard Health Deficiencies
8
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
76
Cycle 1 Standard Survey Health Date
2014-12-09
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
76
Cycle 2 Total Number of Health Deficiencies
6
Cycle 2 Number of Standard Health Deficiencies
6
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
52
Cycle 2 Standard Health Survey Date
2013-10-17
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
52
Cycle 3 Total Number of Health Deficiencies
4
Cycle 3 Number of Standard Health Deficiencies
3
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
32
Cycle 3 Standard Health Survey Date
2012-07-31
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
32
Total Weighted Health Survey Score
60.66700
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
2
Number of Fines
1
Total Amount of Fines in Dollars
8775
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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