Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
ZIONSVILLE MEADOWS
 
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: 675 S FORD RD
City: ZIONSVILLE
Telephone: (317) 873-5205
Web Site:  
 
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
 
LICENSE INFORMATION:
  License number: 17-000538-1
  License effective date: 10/01/2017
  License expiration date: 09/30/2018
 


Administration and Staff

Administrator: CATHY S GREENE
  Start date: 07/31/2017
 
Director of Nursing: CHRIS TAYLOR
  Start date: 03/07/2016
 
Medical director:  
  Start date:   /  /  
 
Wound care specialist:  
  Start date:   /  /  
 
Infection preventionist:  
  Start date:   /  /  
 


Ownership

CURENT OWNERSHIP:
 
Owning corporation: HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY
3838 N RURAL ST
INDIANAPOLIS IN 46205
 
Ownership type:  OTHER
 
Officer(s): GREGORY FEHRIBACH
            MATTHEW GUTWEIN
            DANIEL SELLERS
            JAMES MINER
            DAVID CANAL
            CHARLES EBERHARDT II
            JOYCE ROGERS
            VIRGINIA CAINE
            LISA HARRIS
            CARL DRUMMER
            SHELIA GUENIN
            ELLEN QUIGLEY
 
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: N/A
Date of last change of ownership: N/A
 


Bed Counts and Census

COMPREHENSIVE CARE BEDS:
Number of Medicaid beds (NF):                     0
Number of Medicare beds (SNF):                    18
Number of Medicare/Medicaid beds (SNF/NF):        167
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     185
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            102
 
Total number of beds in facility:            287
 
CENSUS:
Facility census:  127
As reported by the facility on: 01/08/2018
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 01/08/2018
 
Residential care beds occupied:  27
As reported by the facility on: 01/08/2018
 
Alzheimer Beds:  52
Alzheimer Beds Occupied:  50
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: 185
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: 185
 
  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 - REGGIE CARNEY
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. MAINTENANCE SUPERVIS
Date form completed - 01/23/2015
 


Nurse Aide Training

NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 10/01/2017
Nurse aide training and competency evaluation program (NATCEP) expires: 09/30/2018
Nurse aide training and competency evaluation program (NATCEP) banned: Yes
Nurse aide training and competency evaluation program (NATCEP) ban expires: 05/18/2013
 
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: 
     CNA INSTITUTE OF INDIANA
         Approved: 04/02/2008
         Terminated: 05/19/2011
     IVY TECH COMMUNITY COLLEGE
         Approved: 07/23/2007
         Terminated: 05/19/2011
     NURSE AIDE TRAINING CENTER INC
         Approved: N/A
         Terminated: 05/19/2011
     ASC TRAINING CENTER
         Approved: 05/31/2013
         Terminated: N/A
     PIKE CAREER AND STEM CENTER
         Approved: 07/22/2015
         Terminated: N/A
     PRIMEWAY INSTITUTE
         Approved: 11/04/2009
         Terminated: 05/19/2011
     DAY SPRING CAREER INSTITUTE
         Approved: 04/25/2016
         Terminated: N/A
 


Complaints

NUMBER OF SUBSTANTIATED COMPLAINTS: 
 
  Current year:  1
  Previous year:  0
  2 years previous:  0

 


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
Yes
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: 5Y1W11
  Action - Citation / Fine
  Notice to facility: 04/01/2016
             Appeal: N/A
  Action Cease/Recind: 04/14/2016
         Case Closed: 04/14/2016
  Initial Amount: $3000
Event ID: K3NQ11
  Action - Citation / Fine
  Notice to facility: N/A
             Appeal: N/A
  Action Cease/Recind: 01/12/2016
         Case Closed: 01/12/2016
  Initial Amount: $3000
Event ID: L27S11
  Action - Citation / Fine
  Notice to facility: N/A
             Appeal: N/A
  Action Cease/Recind: N/A
         Case Closed: N/A
  Initial Amount: $1000
Event ID: Q84911
  Action - Citation / Fine
  Notice to facility: 03/06/2003
             Appeal: N/A
  Action Cease/Recind: 03/18/2003
         Case Closed: 03/18/2003
  Initial Amount: $5000
Event ID: 5381
  Notice to facility: 04/28/1999
             Appeal: 05/11/1999
  Action Cease/Recind: 10/14/2001
         Case Closed: 10/14/2001
  Initial Amount: $0
Event ID: 5382
  Notice to facility: N/A
             Appeal: N/A
  Action Cease/Recind: N/A
         Case Closed: N/A
  Initial Amount: $0
Event ID: 5383
  Action - Citation / Fine
  Notice to facility: 08/06/1998
             Appeal: 09/01/1998
  Action Cease/Recind: 10/18/2000
         Case Closed: N/A
  Initial Amount: $6500
 
Federal Certification Actions Imposed
     Discretionary Deny Pay for New Admits
     Date Imposed: 05/06/2018  Date Ended: 05/02/2018
     Civil Money Penalty
     Date Imposed: 08/25/2017  Date Ended: 08/25/2017
     Amount proposed per day: 
     Civil Money Penalty
     Date Imposed: 01/28/2016  Date Ended: 02/26/2016
     Amount proposed per day: 350
 
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

ZGDL12
Follow Up, Recertification, State Licensure
05/04/2018


SVKF12
Complaint, Follow Up
05/04/2018


ZGDL22
Follow Up, Life Safety Code, Recertification
04/18/2018


SVKF11
Complaint
04/12/2018


ZGDL21
Recertification, Life Safety Code
03/06/2018


ZGDL11
Recertification, Complaint, State Licensure
02/20/2018


03J911
Complaint
11/14/2017


71VH11
Complaint
10/17/2017


7W0J11
Complaint
08/14/2017


O2MT12
Follow Up, Recertification, State Licensure
06/02/2017


O2MT22
Recertification, Follow Up, Life Safety Code
05/11/2017


7KS111
Complaint
04/13/2017


O2MT11
Recertification, State Licensure
04/13/2017


O2MT21
Life Safety Code, Recertification
04/12/2017


474411
Complaint
03/15/2017


PQDR11
Complaint
02/13/2017


71C611
Complaint
01/24/2017


DFTQ11
Complaint
01/11/2017


W5SB11
Complaint
11/16/2016


T6LY11
Complaint
10/11/2016


KWKG11
Complaint
08/30/2016


MEE011
Complaint
07/28/2016


IXT411
Complaint
05/26/2016


TG0511
Complaint
04/27/2016


7CG322
Recertification, Follow Up, Life Safety Code
04/07/2016


7CG312
Follow Up, Recertification, State Licensure
03/14/2016


7CG321
Life Safety Code, Recertification
02/10/2016


7CG311
Recertification, State Licensure
01/28/2016


5Y1W12
Complaint, Follow Up
10/28/2015


K3NQ12
Complaint, Follow Up
10/28/2015


5Y1W11
Complaint
09/29/2015


K3NQ11
Complaint
08/05/2015


 
 


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.