Mulberry Health & Rehabilitation Center
502 W Jackson St, Mulberry, IN 46058


Mulberry Health & Rehabilitation Center is nursing home registered in the Centers for Medicare & Medicaid Services (CMS). The Provider Number is 155600. The address is 502 W Jackson St, Mulberry, IN 46058. The zip code is 46058. The phone number is 7652962911.


Mulberry Health & Rehabilitation Center · 502 W Jackson St, Mulberry, IN 46058

Federal Provider Number 155600
Provider Name MULBERRY HEALTH & REHABILITATION CENTER
Address 502 W JACKSON ST
MULBERRY, IN 46058
Phone Number 7652962911
SSA County Code 110
County Name Clinton
Ownership Type Non profit - Corporation
Certified Beds 149
Certified Beds Residents 119
Provider Type Medicare and Medicaid
Resides in Hospital false
Legal Business Name HENRY COUNTY MEMORIAL HOSPITAL
Date First Approved to Provide Medicare Medicaid Services 07/12/1996
Continuing Care Retirement Community true
Special Focus Facility false
Most Recent Health Inspection More Than 2 Years Ago false
Changed Ownership Last 12 Months false
With Resident Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 5
Health Inspection Rating 3
Quality Measure Rating 5
Staffing Rating 4
RN Staffing Rating 4
Reported CNA Staffing Hours per Resident per Day 2.32227
Reported LPN Staffing Hours per Resident per Day 1.02185
Reported RN Staffing Hours per Resident per Day 0.73529
Reported Licensed Staffing Hours per Resident per Day 1.75714
Reported Total Nurse Staffing Hours per Resident per Day 4.07941
Reported Physical Therapist Staffing Hours per Resident Per Day 0.14034
Expected CNA Staffing Hours per Resident per Day 2.5989
Expected LPN Staffing Hours per Resident per Day 0.62363
Expected RN Staffing Hours per Resident per Day 0.99902
Expected Total Nurse Staffing Hours per Resident per Day 4.22154
Adjusted CNA Staffing Hours per Resident per Day 2.19253
Adjusted LPN Staffing Hours per Resident per Day 1.36001
Adjusted RN Staffing Hours per Resident per Day 0.54995
Adjusted Total Nurse Staffing Hours per Resident per Day 3.89519
Cycle 1 Total Number of Health Deficiencies 1
Cycle 1 Number of Standard Health Deficiencies 1
Cycle 1 Health Deficiency Score 16
Cycle 1 Standard Survey Health Date 02/29/2016
Cycle 1 Number of Health Revisits 1
Cycle 1 Total Health Score 16
Cycle 2 Total Number of Health Deficiencies 5
Cycle 2 Number of Standard Health Deficiencies 5
Cycle 2 Health Deficiency Score 64
Cycle 2 Standard Health Survey Date 03/04/2015
Cycle 2 Number of Health Revisits 1
Cycle 2 Total Health Score 64
Cycle 3 Total Number of Health Deficiencies 1
Cycle 3 Number of Standard Health Deficiencies 1
Cycle 3 Standard Health Survey Date 02/21/2014
Total Weighted Health Survey Score 29.333
Total Amount of Fines in Dollars $0.00
Processing Date 08/01/2017

Owner or Manager · Mulberry Health & Rehabilitation Center

Owner Name Role Association Date
BRAMMER, DUANE (Individual) DIRECTOR since 01/01/2013
DYNES, SHELDON (Individual) DIRECTOR since 01/01/2013
HENRY COUNTY MEMORIAL HOSPITAL (Organization) 5% OR GREATER DIRECT OWNERSHIP INTEREST
100%
since 01/01/2013
JANSSEN, PAUL (Individual) DIRECTOR since 01/01/2013
JANSSEN, PAUL (Individual) OFFICER since 01/01/2013
PIDGEON, JOHN (Individual) DIRECTOR since 01/01/2013
SHORE, MARION (Individual) DIRECTOR since 01/01/2013
WALLAR, HEIDI (Individual) MANAGING EMPLOYEE since 01/01/2013
WOLFSCHLAG, MARK (Individual) MANAGING EMPLOYEE since 01/01/2013

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