Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
APERION CARE ARBORS MICHIGAN CITY
 
NURSING HOME
SKILLED NURSING FACILITY / NURSING FACILITY DISTINCT PART
Created on: 06/08/2018
 
Posted to the Web on: 06/20/2018
 
 



Basic Information

FACILITY CONTACT INFORMATION:
Address: 1101 E COOLSPRING AVE
City: MICHIGAN CITY
Telephone: (219) 874-5211
Web Site:  
 
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
 
LICENSE INFORMATION:
  License number: 18-000076-1
  License effective date: 03/01/2018
  License expiration date: 02/28/2019
 


Administration and Staff

Administrator: DAVID HENKE
  Start date: 06/23/2017
 
Director of Nursing: MELISSA HALL
  Start date: 09/18/2015
 
Medical director:  
  Start date:   /  /  
 
Wound care specialist:  
  Start date:   /  /  
 
Infection preventionist:  
  Start date:   /  /  
 


Ownership

CURENT OWNERSHIP:
 
Owning corporation: MAJOR HOSPITAL
2451 INTELLPLEX DR
SHELBYVILLE IN 46176
 
Ownership type:  OTHER
 
Officer(s): DANA CALDWELL
            DOUGLAS CARTER MD
            JEFF BEATY
            JOHN COFFIN
            JAN SANDMAN
            SHERRI TANDY
            JOHN HORNER
            GENE JONES
            RALPH MERCURI
            LINDA WESSIC
 
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: THE ARBORS OPERATOR, LLC
Date of last change of ownership: 03/01/2013
 


Bed Counts and Census

COMPREHENSIVE CARE BEDS:
Number of Medicaid beds (NF):                     0
Number of Medicare beds (SNF):                    33
Number of Medicare/Medicaid beds (SNF/NF):        147
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     180
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            0
 
Total number of beds in facility:            180
 
CENSUS:
Facility census:  124
As reported by the facility on: 04/23/2018
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 04/23/2018
 
Residential care beds occupied:  0
As reported by the facility on: 04/23/2018
 
Alzheimer Beds:  38
Alzheimer Beds Occupied:  22
As reported by the facility on:   /  /  
 
Ventilator Beds:  0
Ventilator Beds Occupied:  0
As reported by the facility on:   /  /  
 


Sprinklers and Smoke Detectors

This facility is: FULLY SPRINKLERED
 
Number of comprehensive care resident rooms: 152
Number of comprehensive care resident rooms with battery 
                    operated smoke detectors: 0
Number of comprehensive care resident rooms 
             with hard wired and/or wireless smoke detectors: 152
 
  If hard wired and/or wireless smoke detectors are provided in resident's room, do they:
    (A) Provide a visual and audible signal at the nurses'stations that attend each room? - Yes
    (B) Transmit to a central station service - Yes
    (C) Connect to the health facility's fire alarm system - Yes
 
Person completing form - DAVID E. HENKE
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. EXECUTIVE DIRECTOR
Date form completed - 02/12/2018
 


Nurse Aide Training

NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 03/22/2000
Nurse aide training and competency evaluation program (NATCEP) expires: 04/01/2002
Nurse aide training and competency evaluation program (NATCEP) banned: Yes
Nurse aide training and competency evaluation program (NATCEP) ban expires: 06/12/2019
 
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: 
     MED ED INCORPORATED
         Approved: 06/17/2009
         Terminated: 03/05/2015
     A K SMITH CAREER CENTER
         Approved: 05/11/2009
         Terminated: 03/05/2015
     IN TRAINING COLLEGE OF ADULT EDUCATION
         Approved: 04/09/1997
         Terminated: 01/29/2002
     MICHIGAN CITY HIGH SCHOOL HEALTH OCCUPATIONS
         Approved: 05/28/1997
         Terminated: 01/29/2002
     PROFESSIONAL RESOURCES
         Approved: 04/26/1996
         Terminated: 01/29/2002
     APERION CARE ARBORS MICHIGAN CITY
         Approved: 03/18/1996
         Terminated: 05/09/2007
 


Complaints

NUMBER OF SUBSTANTIATED COMPLAINTS: 
 
  Current year:  2
  Previous year:  7
  2 years previous:  4

 


Facility Report Card



 
   We are experiencing technical issues with the consumer report card system.
   We are working to resolve the issue.

 
The statewide average line is being provided to give you a reference
for looking at the scores of the selected facility.  This row 
contains the mean average calculated scores for all facilities as of
above date resulting in a scoring range of 0 to 587.
Scores are considered to be better the closer to zero they are.
Percentile rank of 100 represents the lowest report card score or best performing facility,
with a rank of 1 being the highest report card score.
 
View the Scope and Severity grid
 
View the scoring methodology
 



Overview of Survey findings




 
 The Most Recent Set
 2ND Most Recent Set
 3RD Most Recent Set

Immediate Jeopardy
Yes
Yes
No


 Substandard Quality of Care 
Yes
Yes
No


Administrator Change
Yes
No
Yes


Owner Change
No
No
No


Number of Substantiated Complaints With Deficiencies
0
0
0


Deficiency Free Standard Health Survey
No
No
No


 
    The term 'Recent Set' referenced above relates to the referenced annual survey,
    and any other surveys performed between it and the previous annual survey.
 

 


Enforcement Actions

Event ID: CNUI11
  Action - Citation / Fine
  Notice to facility: 12/09/2014
             Appeal: N/A
  Action Cease/Recind: 06/11/2015
         Case Closed: 06/11/2015
  Initial Amount: $3000
Event ID: DRFN11
  Action - Citation / Fine
  Notice to facility: 06/24/2005
             Appeal: N/A
  Action Cease/Recind: 12/13/2006
         Case Closed: 12/13/2006
  Initial Amount: $6750
Event ID: JACK11
  Action - Citation / Fine
  Notice to facility: 01/08/2004
             Appeal: N/A
  Action Cease/Recind: 01/25/2005
         Case Closed: 01/25/2005
  Initial Amount: $3750
Event ID: 
  Action - Citation / Fine
  Notice to facility: 01/31/2000
             Appeal: 02/17/2000
  Action Cease/Recind: 06/15/2000
         Case Closed: N/A
  Initial Amount: $3000
 
Federal Certification Actions Imposed
     Directed Plan of Correction
     Date Imposed: 04/30/2018  Date Ended: 04/17/2018
     Civil Money Penalty
     Date Imposed: 06/12/2017  Date Ended: 07/23/2017
     Amount proposed per day: 710
     Amount proposed per day: 9049
     Civil Money Penalty
     Date Imposed: 12/21/2015  Date Ended: 01/21/2016
     Amount proposed per day: 550
     Amount proposed per day: 4550
     Amount proposed per day: 550
 
Date terminated from Medicare/Medicaid: N/A
 


Survey History


    The survey report is not posted until the report has been provided to the facility and their plan of correction submitted and approved.
    The survey report therefore will likely not be posted until four to six weeks after the exit date.
        
    In the grid below click on an event ID that is underlined to see the survey report for that event.

        
          

          

 
Event ID
Survey Type
Exit Date

MSMD11
Complaint
05/23/2018


HPYD22
Follow Up, Life Safety Code, Other
05/15/2018


RO5U12
Complaint, Follow Up
05/01/2018


RO5U11
Complaint
04/18/2018


XSCK23
Recertification, Follow Up, Life Safety Code
04/17/2018


HPYD21
Life Safety Code, Other
04/03/2018


XSCK22
Recertification, Follow Up, Life Safety Code
04/03/2018


9TEC12
Complaint, Follow Up
03/16/2018


XSCK21
Recertification, Life Safety Code
02/01/2018


9TEC11
Complaint
01/30/2018


XSCK12
Recertification, Follow Up, State Licensure
01/24/2018


XSCK11
Recertification, State Licensure
12/18/2017


OXGY11
Complaint
11/27/2017


ZWGG11
Complaint
11/01/2017


IT2J11
Complaint
10/05/2017


YW7I11
Complaint
09/11/2017


03V412
Complaint, Follow Up
08/08/2017


ZBXX12
Complaint, Follow Up
08/08/2017


ZBXX11
Complaint
06/29/2017


03V411
Complaint
06/13/2017


FT7D12
Complaint, Follow Up
06/13/2017


VEUM11
Complaint
05/19/2017


FT7D11
Complaint
05/11/2017


4J6Z12
Complaint, Follow Up
03/10/2017


7J7B11
Complaint
02/22/2017


4J6Z11
Complaint
02/07/2017


O5B022
Recertification, Follow Up, Life Safety Code
01/25/2017


O6SK11
Complaint
12/29/2016


BP1K12
Complaint, Follow Up
12/29/2016


1NWQ12
Complaint, Follow Up
12/29/2016


O5B012
Complaint, Follow Up, Recertification, State Licensure
12/29/2016


O5B021
Recertification, Life Safety Code
12/13/2016


BP1K11
Complaint
11/27/2016


1NWQ11
Complaint
10/29/2016


O5B011
Complaint, Recertification, State Licensure
10/28/2016


RRX112
Complaint, Follow Up
10/20/2016


RRX111
Complaint
09/23/2016


OQNU11
Complaint
08/15/2016


RC6E11
Complaint
07/01/2016


8I2P21
Life Safety Code, Other
05/13/2016


19WU12
Complaint, Follow Up
03/08/2016


D2DQ12
Recertification, Complaint, Follow Up, State Licensure
03/08/2016


HM6W11
Complaint
03/08/2016


D2DQ22
Recertification, Follow Up, Life Safety Code
03/04/2016


19WU11
Complaint
01/26/2016


D2DQ21
Life Safety Code, Recertification
01/20/2016


D2DQ11
Complaint, Recertification, State Licensure
12/21/2015


GXSW11
Complaint
08/26/2015


X70Q11
Complaint
07/31/2015


YU9Y12
Complaint, Follow Up
06/24/2015


 
 


Links and Resources

 
CMS nursing home compare page 
 
    In addition to the information provided on this 
    web site, the Centers for Medicare & Medicaid Services (CMS) has a web site 
    which contains information on every Medicare and Medicaid certified nursing 
    home in the country. The CMS nursing home survey results contain summary information 
    about a facility's noncompliance of regulations regarding the care of residents 
    found in the nursing homes. You can locate nursing homes in your area and find 
    information about compliance with federal regulations.
 
Resources and links to other organizations
 
Choosing a Nursing Home
 
Overview of the Survey Process
 
State Wide Grouping of all Scores
   
Overview of current comprehensive facility scores
   
Spreadsheet of current comprehensive facility names and scores
   
Legal Disclaimer for Long Term Care Reports.