Overall Rating
Address
8405 Clearvista Place
Indianapolis, IN 46256
Contact
3175787500
Certification Date
2014-02-26
CMS Certification Number
155815
Ownership Type
Non profit - Other
Number of Certified Beds
70
Average Number of Residents per Day
38.0
Provider Type
Medicare and Medicaid
Legal Business Name
WITHAM MEMORIAL HOSPITAL
Affiliated Entity Name
TRILOGY HEALTH SERVICES
Affiliated Entity ID
524
Health Inspection Rating
1
Quality Measure Rating
5
Staffing Rating
2
Reported Nurse Aide Staffing Hours per Resident per Day
1.95649
Reported LPN Staffing Hours per Resident per Day
1.15211
Reported RN Staffing Hours per Resident per Day
0.90525
Reported Total Nurse Staffing Hours per Resident per Day
4.01385
Total Number of Nurse Staff Hours per Resident per Day on the Weekend
3.40580
Registered Nurse Hours per Resident per Day on the Weekend
0.49336
Reported Physical Therapist Staffing Hours per Resident Per Day
0.11314
Long-Stay Quality Measure Rating
4
Short-Stay Quality Measure Rating
5
Total Weighted Health Survey Score
104.000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
15
Number of Citations from Infection Control Inspections
0
Standard Health Survey Date
2023-08-22
Total Number of Health Deficiencies
12
Number of Standard Health Deficiencies
11
Number of Complaint Health Deficiencies
1
Health Deficiency Score
72
Number of Health Revisits
1
Health Revisit Score
0
Total Health Score
72
Standard Health Survey Date
2022-03-16
Total Number of Health Deficiencies
28
Number of Standard Health Deficiencies
22
Number of Complaint Health Deficiencies
11
Health Deficiency Score
168
Number of Health Revisits
1
Health Revisit Score
0
Total Health Score
168
Standard Health Survey Date
2019-07-01
Total Number of Health Deficiencies
8
Number of Standard Health Deficiencies
8
Number of Complaint Health Deficiencies
0
Health Deficiency Score
72
Number of Health Revisits
1
Health Revisit Score
0
Total Health Score
72
Number of Fines
2
Total Amount of Fines in Dollars
45366.75
Number of Payment Denials
0
Total Number of Penalties
2