Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
WATERS OF SCOTTSBURG, THE
 
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: 1350 N TODD DR
City: SCOTTSBURG
Telephone: (812) 752-5663
Web Site:  
 
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
 
LICENSE INFORMATION:
  License number: 17-000478-1
  License effective date: 09/01/2017
  License expiration date: 08/31/2018
 


Administration and Staff

Administrator: CAROL ROSEMEYER
  Start date: 07/11/2016
 
Director of Nursing: DEBRA GOBEN
  Start date: 09/06/2016
 
Medical director:  
  Start date:   /  /  
 
Wound care specialist:  
  Start date:   /  /  
 
Infection preventionist:  
  Start date:   /  /  
 


Ownership

CURENT OWNERSHIP:
 
Owning corporation: DEARBORN COUNTY HOSPITAL
600 WILSON CREEK RD
DEARBORN IN 47025
 
Ownership type:  OTHER
 
Officer(s): ALBERT KEN INGRAM
            ROBERT SCHROEDER
            RONALD DENNEY
            CARL PETTY
            BETTY BISCHOFF
            WILLIAM RITZMANN
            ROBERT MOORHEAD
            MICHAEL SCHWEBLER
 
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: THE WATERS OF SCOTTSBURG II 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):        99
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     99
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            0
 
Total number of beds in facility:            99
 
CENSUS:
Facility census:  59
As reported by the facility on: 01/04/2018
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 01/04/2018
 
Residential care beds occupied:  0
As reported by the facility on: 01/04/2018
 
Alzheimer Beds:  26
Alzheimer Beds Occupied:  19
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: 55
Number of comprehensive care resident rooms with battery 
                    operated smoke detectors: 55
Number of comprehensive care resident rooms 
             with hard wired and/or wireless smoke detectors: 0
 
Person completing form - SHAWN COLWELL
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. MAINTENANCE SUPERVIS
Date form completed - 03/29/2017
 


Nurse Aide Training

NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 02/16/2000
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: 07/10/2018
 
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: 
     WATERS OF SCOTTSBURG, THE
         Approved: 03/07/2000
         Terminated: 07/16/2013
     INDIANA HEALTH CAREERS VOCATIONAL TRAINING &  TEST
         Approved: 08/11/2015
         Terminated: 07/11/2016
 


Complaints

NUMBER OF SUBSTANTIATED COMPLAINTS: 
 
  Current year:  0
  Previous year:  0
  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 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 
No
Yes
No


Administrator Change
No
Yes
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: L4BN11
  Action - Citation / Fine
  Notice to facility: 10/16/2012
             Appeal: N/A
  Action Cease/Recind: 11/30/2012
         Case Closed: 11/30/2012
  Initial Amount: $5000
Event ID: BGB211
  Notice to facility: 06/01/2007
             Appeal: N/A
  Action Cease/Recind: 03/14/2008
         Case Closed: 03/14/2008
  Initial Amount: $0
Event ID: V3KU11
  Notice to facility: 08/25/2006
             Appeal: N/A
  Action Cease/Recind: 10/02/2006
         Case Closed: 10/02/2006
  Initial Amount: $0
 
Federal Certification Actions Imposed
     Civil Money Penalty
     Date Imposed: 03/29/2017  Date Ended: 03/29/2017
     Amount proposed per day: 
     Civil Money Penalty
     Date Imposed: 06/22/2016  Date Ended: 08/01/2016
     Amount proposed per day: 5950
     Amount proposed per day: 250
 
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

MF2R21
Recertification, Life Safety Code
01/29/2018


MF2R12
Recertification, Follow Up, State Licensure
01/23/2018


MF2R11
Recertification, State Licensure
12/15/2017


8R2J11
Complaint
11/13/2017


K93E11
Complaint
07/20/2017


YNQ222
Follow Up, Life Safety Code, Recertification
05/25/2017


ECV011
Complaint
04/24/2017


YNQ221
Recertification, Life Safety Code
03/29/2017


YNQ212
Recertification, Follow Up, State Licensure
03/29/2017


YNQ211
Recertification, Complaint, State Licensure
02/24/2017


RNN012
Complaint, Follow Up
08/29/2016


U76311
Complaint
08/29/2016


5XDC12
Complaint, Follow Up
07/11/2016


RNN011
Complaint
07/11/2016


5XDC11
Complaint
06/02/2016


KLQW11
Complaint
04/27/2016


G5NO22
Recertification, Follow Up, Life Safety Code
03/11/2016


RBFM11
Complaint
03/03/2016


G5NO12
Recertification, Follow Up, State Licensure
02/29/2016


G5NO21
Life Safety Code, Recertification
02/11/2016


G5NO11
Recertification, State Licensure
02/01/2016


3BTU11
Complaint
12/03/2015


G8DH12
Follow Up, Recertification, State Licensure
10/20/2015


CN9512
Complaint, Follow Up
10/20/2015


G8DH22
Follow Up, Life Safety Code, Recertification
10/13/2015


G8DH21
Life Safety Code, Recertification
09/14/2015


CN9511
Complaint
09/08/2015


G8DH11
Recertification, Complaint, State Licensure
08/10/2015


9WXZ12
Complaint, Follow Up
07/02/2015


 
 


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.