Created on: 06/08/2018
Posted to the Web on: 06/20/2018
Basic Information
FACILITY CONTACT INFORMATION:
Address: 7301 E 16TH ST
City: INDIANAPOLIS
Telephone: (317) 353-1290
Web Site:
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
LICENSE INFORMATION:
License number: 18-000227-1
License effective date: 01/01/2018
License expiration date: 12/31/2018
Administration and Staff
Administrator: LINDA VEST
Start date: 03/19/2018
Director of Nursing: REBECCA DUNNUCK
Start date: 05/08/2018
Medical director:
Start date: / /
Wound care specialist: Cynthia Smith
Start date: / /
Infection preventionist:
Start date: / /
Ownership
CURENT OWNERSHIP:
Owning corporation: HANCOCK REGIONAL HOSPITAL
801 NORTH STATE STREET
GREENFIELD IN 46140
Ownership type: OTHER
Officer(s): TIMOTHY CLARK
DIANNE OSBORNE
LINDA ZIMMERMAN
ROY WILSON
DEAN FELKER
STEVEN LONG
JIM MILLER
ANN VAIL
RICK EDWARDS
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: KINDRED NURSING CENTERS LIMITED PARTNERSHIP
Date of last change of ownership:
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): 160
Number of non-certified comprehensive care beds (State Licensed only): 0
Total number of comprehensive care beds: 160
RESIDENTIAL CARE BEDS:
Total number of residential beds: 0
Total number of beds in facility: 160
CENSUS:
Facility census: 145
As reported by the facility on: 01/17/2018
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 01/17/2018
Residential care beds occupied: 0
As reported by the facility on: 01/17/2018
Alzheimer Beds: 0
Alzheimer Beds Occupied: 0
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: 89
Number of comprehensive care resident rooms with battery
operated smoke detectors: 61
Number of comprehensive care resident rooms
with hard wired and/or wireless smoke detectors: 28
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 - SHAWN CLINE
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. MAINTENANCE DIRECTOR
Date form completed - 02/15/2018
Nurse Aide Training
NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 03/10/1998
Nurse aide training and competency evaluation program (NATCEP) expires: 04/01/2000
Nurse aide training and competency evaluation program (NATCEP) banned: Yes
Nurse aide training and competency evaluation program (NATCEP) ban expires: 08/21/2014
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites:
CNA INSTITUTE OF INDIANA
Approved: 07/11/2006
Terminated: 12/28/2006
WALKER CAREER CENTER
Approved: 03/05/2012
Terminated: 08/22/2012
WILDWOOD HEALTHCARE CENTER
Approved: N/A
Terminated: 08/22/2012
NURSE AIDE TRAINING CENTER INC
Approved: 08/08/1996
Terminated: 12/28/2006
PRIMEWAY INSTITUTE
Approved: 11/12/2010
Terminated: 08/22/2012
IVY TECH COMMUNITY COLLEGE
Approved: 09/19/1996
Terminated: 12/28/2006
PRO-VISION TRAINING SERVICES
Approved: 12/02/2014
Terminated: N/A
CNA & HOMECARE TRAINING CENTER, INC
Approved: 07/29/2016
Terminated: N/A
J EVERETT LIGHT CAREER CENTER
Approved: 06/29/2016
Terminated: N/A
READY TO CARE
Approved: 01/08/2018
Terminated: N/A
KINDRED HEALTHCARE
Approved: 07/14/2016
Terminated: N/A
Complaints
NUMBER OF SUBSTANTIATED COMPLAINTS:
Current year: 1
Previous year: 1
2 years previous: 1
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 gridView 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
Yes
No
No
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: YGKW11
Notice to facility: 04/24/2008
Appeal: N/A
Action Cease/Recind: 01/16/2009
Case Closed: 04/01/2009
Initial Amount: $0
Federal Certification Actions Imposed
Civil Money Penalty
Date Imposed: 09/20/2016 Date Ended: 09/20/2016
Amount proposed per day:
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.
