Provider Name: SKILLED CARING CENTER OF MEMORIAL HOSPITAL
Address: 800 W NINTH ST, JASPER, IN 47546
Phone: (812) 482-0674
County: Dubois (180)
Ownership Type: Non profit - Church related
Certified Beds: 14
Average Residents Per Day: 11.4 ()
Provider Type: Medicare and Medicaid, Resides in Hospital: No
Legal Business Name: LITTLE COMPANY OF MARY HOSPITAL OF INDIANA INC
First Approved Date: August 4, 1987
Affiliated Entity: ()
Retirement Community: N, Special Focus Status:
Ownership Change in Last 12 Months: N
Resident Family Council: None
Sprinkler System Status: Yes
Overall Rating: 5 ()
Health Inspection Rating: 5 ()
QM Rating: 5 ()
Long Stay QM Rating: (2)
Short Stay QM Rating: 5 ()
Staffing Rating: 5 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 1.92854, LPN Staff Hours Per Day: 0.2961, RN Staff Hours Per Day: 5.6101, Licensed Staff Hours Per Day: 5.9063
Total Nurse Staff Hours Per Day, per resident: 7.83485
Weekend Nurse Staff Hours: 6.42974, Weekend RN Staff Hours: 4.3104
PT Staff Hours Per Day, per resident: 0.0963
Nurse Staff Turnover: 39.5, Nurse Turnover Note:
RN Turnover: 23.8, RN Turnover Note:
Admin Left Number: 0, Admin Turnover Note:
Case Mix Nurse Aide Hours Per Day, per resident: 2.0607, Case Mix LPN Hours Per Day: 0.8765, Case Mix RN Hours Per Day: 0.5364
Adjusted Nurse Aide Hours Per Day, per resident: 1.90659, Adjusted LPN Hours Per Day: 0.2493, Adjusted RN Hours Per Day: 3.9408
Total Adjusted Nurse Hours Per Day, per resident: 7.10931
Adjusted Weekend Nurse Hours Per Day, per resident: 5.83432
Health Survey Dates and Scores: Cycle 1: 2023-05-05 (Score: 4), Cycle 2: 2022-06-03 (Score: 0), Cycle 3: 2021-04-23 (Score: 0)
Total Weighted Health Score: 2.000
Reported Incidents: 0, Substantiated Complaints: 0
Infection Control Citations:
Fines and Penalties: Number of Fines: 0, Total Fines in Dollars: 0.00, Payment Denials Number: 0, Total Penalties Number: 0
Location and GPS: 800 W NINTH ST,JASPER,IN,47546 (38.3937, -86.942)
Process Date: 2024-03-01
Each record details specific health deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Health, Deficiency: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2023-05-17
Each record details specific fire safety deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Fire Safety, Tag: 0345, Version: New
Description: Have approved installation, maintenance and testing program for fire alarm systems.
Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2023-06-01
Type: Fire Safety, Tag: 0531, Version: New
Description: Have elevators that firefighters can control in the event of a fire.
Severity: C - Level 1: No actual harm with potential for minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has plan of correction on 2021-05-20