Brookside Village Inc
Brookside Village Inc Information
| Facility Name | Brookside Village Inc |
| Location | 1111 Church Ave, Jasper, IN 47546 |
| County (SSA Code) | Dubois (180) |
| Phone Number | 812-634-7750 |
| Certification(s) | Medicare and Medicaid |
| Number of Beds | 27 |
| Average Number of Residents | 19.3 |
| CCRC Facility? | No |
| Medicare Overall Rating | |
| Survey Rating | |
| Quality Rating | |
| Long Stay Quality Rating | |
| Short Stay Quality Rating | |
| Staff Quality Rating | |
| Registered Nurse Quality Rating |
| Abuse Flag | No |
| Sprinklers Installed | Yes |
| Located In Hospital | No |
| Resident Family Council | Resident |
| Provider Business Name | BROOKSIDE VILLAGE, INC |
| Ownership Type | For profit - Corporation |
| Date First Approved | 2002-07-25 |
| Reported Nurse Aide Staffing Hours per Resident per Day | 1.9041 |
| Reported LPN Staffing Hours per Resident per Day | 1.80032 |
| Reported RN Staffing - Hours per Resident per Day | 1.07124 |
| Reported Licensed Staffing - Hours per Resident per Day (RN + LPN) | 2.87157 |
| Reported Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 4.77566 |
| Reported Physical Therapy Staffing - Hours per Resident Per Day | 0.20862 |
| Case-Mix Nurse Aide Staffing - Hours per Resident per Day | 2.2698 |
| Case-Mix LPN Staffing - Hours per Resident per Day | 0.73728 |
| Case-Mix RN Staffing - Hours per Resident per Day | 0.32115 |
| Case-Mix Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 3.32823 |
| Adjusted Total Nurse Staffing - Hours per Resident per Day (Aide+LPN+RN) | 4.57471 |
| Total Weighted Health Survey Score for three cycles | 10 |
| Rating cycle 1 Standard Survey Health Date | 2019-09-27 |
| Rating cycle 1 - Health Deficiency Score | 1 |
| Rating cycle 1 - Total Health Inspection Score | 20 |
| Date of Rating cycle 2 Standard Health Survey Date | 2018-10-10 |
| Rating cycle 2 - Health Deficiency Score | 20 |
| Date of Rating cycle 3 Standard Health Survey Date | 2017-08-03 |
| Rating cycle 3 - Health Deficiency Score | 8 |
| Rating cycle 3 - Total Health Inspection Score | 8 |
| Number of Facility-Reported Incidents | 0 |
| Number of Substantiated Complaints | 0 |
| Number of Substantiated Complaints | 0 |
| Total Number of Penalties | 0 |
| Data Filing Date | 2020-10-01 |
| Page Last Updated | 2020-11-28 |