Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
GOLDEN LIVING CENTER-FOUNTAINVIEW PLACE
 
NURSING HOME
SKILLED NURSING FACILITY / NURSING FACILITY DUALLY CERTIFIED
Created on: 06/08/2018
 
Posted to the Web on: 06/20/2018
 
 



Basic Information

FACILITY CONTACT INFORMATION:
Address: 3175 LANCER ST
City: PORTAGE
Telephone: (219) 762-9571
Web Site:  
 
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
 
LICENSE INFORMATION:
  License number: 17-000098-1
  License effective date: 09/01/2017
  License expiration date: 08/31/2018
 


Administration and Staff

Administrator: JASON EASTLUND
  Start date: 08/12/2016
 
Director of Nursing: TAMARA BARACK
  Start date: 09/05/2017
 
Medical director: Thomas Devine
  Start date:   /  /  
 
Wound care specialist:  
  Start date:   /  /  
 
Infection preventionist:  
  Start date:   /  /  
 


Ownership

CURENT OWNERSHIP:
 
Owning corporation: HENDRICKS COUNTY HOSPITAL
1000 EAST MAIN STREET
DANVILLE IN 46122
 
Ownership type:  OTHER
 
Officer(s): KEVIN SPEER
            TERRY DILLON
            MIKE EDMONDSON
            ERIN ENGELS
            YVONNE CULPEPPER
            DENNIS RESSLER
            WESLEY ROGERS
            TINA CHAVIS
            LARRY JOSEPH
            SALVATORE SALAMONE
            HOLLY RASMUSSAN-JONES
            ANN TRUITT
            GREG SWARTZ
            ROBERTA WILLIAMS
 
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: FOUNTAINVIEW PORTAGE OPERATING LLC
Date of last change of ownership: 09/01/2012
 


Bed Counts and Census

COMPREHENSIVE CARE BEDS:
Number of Medicaid beds (NF):                     0
Number of Medicare beds (SNF):                    0
Number of Medicare/Medicaid beds (SNF/NF):        186
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     186
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            0
 
Total number of beds in facility:            186
 
CENSUS:
Facility census:  145
As reported by the facility on: 01/30/2018
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 01/30/2018
 
Residential care beds occupied:  0
As reported by the facility on: 01/30/2018
 
Alzheimer Beds:  36
Alzheimer Beds Occupied:  35
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: 94
Number of comprehensive care resident rooms with battery 
                    operated smoke detectors: 94
Number of comprehensive care resident rooms 
             with hard wired and/or wireless smoke detectors: 0
 
Person completing form - DANIEL WILSON
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. MAINTENANCE DIRECTOR
Date form completed - 02/14/2018
 


Nurse Aide Training

NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 04/20/2005
Nurse aide training and competency evaluation program (NATCEP) expires: 04/01/2009
Nurse aide training and competency evaluation program (NATCEP) banned: Yes
Nurse aide training and competency evaluation program (NATCEP) ban expires: 10/15/2017
 
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: 
     GOLDEN LIVING CENTER-MERRILLVILLE
         Approved: 04/13/2004
         Terminated: 08/03/2005
     PORTER COUNTY CAREER CENTER
         Approved: 01/19/2010
         Terminated: 12/13/2013
     SPECIALIZED MEDICAL EDUCATION AND TRAINING
         Approved: 03/16/2001
         Terminated: 12/13/2013
     GOLDEN LIVING TRAINING CENTER
         Approved: 03/04/2010
         Terminated: 12/13/2013
     CNA ACADEMY
         Approved: 05/26/2010
         Terminated: 12/13/2013
     IVY TECH COMMUNITY COLLEGE
         Approved: 02/14/2011
         Terminated: 12/13/2013
     CARETECH HEALTHCARE TRAINING
         Approved: 12/15/2011
         Terminated: 12/13/2013
     HEALTHCARE TRAINING SOLUTIONS
         Approved: 02/22/2012
         Terminated: 12/13/2013
     DIXIE MEDICAL EDUCATION TRAINING
         Approved: 08/27/2012
         Terminated: 12/13/2013
     SAVING A GENERATION (SAG) INC
         Approved: 09/28/2011
         Terminated: 12/13/2013
     MEDICAL CAREER ACADEMY
         Approved: 07/23/2013
         Terminated: 12/13/2013
     GOLDEN LIVING CENTER-FOUNTAINVIEW PLACE
         Approved: 09/08/1999
         Terminated: 12/13/2013
     IVY TECH CORPORATE COLLEGE
         Approved: 03/21/2013
         Terminated: 12/13/2013
     IN TRAINING COLLEGE OF ADULT EDUCATION
         Approved: 05/29/2018
         Terminated: N/A
 


Complaints

NUMBER OF SUBSTANTIATED COMPLAINTS: 
 
  Current year:  2
  Previous year:  8
  2 years previous:  6

 


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
No
No
No


 Substandard Quality of Care 
No
No
No


Administrator Change
No
Yes
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: 
  Action - Emergency order ban on admissions
  Notice to facility: 08/06/1998
             Appeal: 08/17/1998
  Action Cease/Recind: 10/30/1998
         Case Closed: 02/22/1999
  Initial Amount: $0
Event ID: 
  Action - Emergency order placement of monitor
  Notice to facility: 08/06/1998
             Appeal: 08/12/1998
  Action Cease/Recind: 10/30/1998
         Case Closed: 02/22/1999
  Initial Amount: $0
Event ID: 
  Notice to facility: 08/07/1998
             Appeal: 08/17/1998
  Action Cease/Recind: 08/31/1998
         Case Closed: 02/22/1999
  Initial Amount: $0
 
Federal Certification Actions Imposed
     Civil Money Penalty
     Date Imposed: 10/12/2016  Date Ended: 11/15/2016
     Amount proposed per day: 703
     Mand. Deny Pay for New Admits-3 Mo.
     Date Imposed: 10/16/2015  Date Ended: 12/07/2015
 
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

C86S12
Complaint, Follow Up
04/27/2018


E0ZV11
Complaint
04/27/2018


XIKN22
Recertification, Follow Up, Life Safety Code
04/03/2018


C86S11
Complaint
03/28/2018


XIKN21
Recertification, Life Safety Code
03/05/2018


XIKN12
Recertification, Follow Up, State Licensure
03/02/2018


XIKN11
Recertification, Complaint, State Licensure
01/23/2018


JGQ312
Complaint, Follow Up
01/13/2018


JGQ311
Complaint
12/14/2017


KRDO12
Complaint, Follow Up
10/20/2017


KRDO11
Complaint
09/19/2017


RP2Z12
Complaint, Follow Up
09/11/2017


RP2Z11
Complaint
08/10/2017


M6IE12
Complaint, Follow Up
07/28/2017


M6IE11
Complaint
06/15/2017


105S12
Complaint, Follow Up
04/04/2017


SXRV11
Complaint
03/23/2017


105S11
Complaint
03/01/2017


IZ7L12
Complaint, Follow Up
02/24/2017


ZNKJ13
Recertification, Follow Up, State Licensure
02/24/2017


ZNKJ22
Recertification, Follow Up, Life Safety Code
02/23/2017


IZ7L11
Complaint
01/27/2017


ZNKJ12
Follow Up, Recertification, State Licensure
01/27/2017


ZNKJ21
Recertification, Life Safety Code
01/18/2017


ZNKJ11
Recertification, State Licensure
12/09/2016


6F2L11
Complaint
11/16/2016


YEFF12
Complaint, Follow Up
11/16/2016


YEFF11
Complaint
10/12/2016


WA4Q11
Complaint
09/01/2016


BA8912
Complaint, Follow Up
09/01/2016


BA8911
Complaint
07/28/2016


5GVK12
Complaint, Follow Up
07/28/2016


5GVK11
Complaint
06/29/2016


G9M511
Complaint
05/09/2016


CTNE11
Complaint
04/07/2016


1CAX11
Complaint
03/14/2016


EM0112
Complaint, Follow Up
03/06/2016


JTIZ12
Complaint, Follow Up
01/28/2016


EM0111
Complaint
01/28/2016


NC7L22
Follow Up, Life Safety Code, Recertification
12/31/2015


JTIZ11
Complaint
12/18/2015


SOFJ13
Complaint, Follow Up
12/08/2015


W2RM12
Complaint, Follow Up
12/08/2015


0C1S13
Complaint, Follow Up
12/08/2015


NC7L12
Complaint, Follow Up, Recertification, State Licensure
12/08/2015


NC7L21
Recertification, Life Safety Code
11/24/2015


NC7L11
Recertification, Complaint, State Licensure
10/30/2015


TR3511
Complaint
10/29/2015


W2RM11
Complaint
10/01/2015


0C1S12
Complaint, Follow Up
10/01/2015


SOFJ12
Complaint, Follow Up
10/01/2015


SOFJ11
Complaint
08/27/2015


0C1S11
Complaint
07/16/2015


 
 


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.