Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
LINCOLNSHIRE HEALTH & REHABILITATION CENTER
 
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: 8380 VIRGINIA ST
City: MERRILLVILLE
Telephone: (219) 769-9009
Web Site:  
 
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
 
LICENSE INFORMATION:
  License number: 18-000577-1
  License effective date: 05/01/2018
  License expiration date: 04/30/2019
 


Administration and Staff

Administrator: RITA GATSON
  Start date: 05/21/2018
 
Director of Nursing: CHRISTINA DOWLING
  Start date: 05/21/2018
 
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: LINCOLNSHIRE HEALTHCARE OPERATIONS COMPANY LLC
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):        100
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     100
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            0
 
Total number of beds in facility:            100
 
CENSUS:
Facility census:  84
As reported by the facility on: 01/15/2018
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 01/15/2018
 
Residential care beds occupied:  0
As reported by the facility on: 01/15/2018
 
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: 100
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: 100
 
  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 - NATHAN WOLF
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. ADMINISTRATOR
Date form completed - 02/13/2018
 


Nurse Aide Training

NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 04/21/2004
Nurse aide training and competency evaluation program (NATCEP) expires: 04/01/2006
Nurse aide training and competency evaluation program (NATCEP) banned: Yes
Nurse aide training and competency evaluation program (NATCEP) ban expires: 08/20/2015
 
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: 
     PURDUE UNIV CALUMET/RESOURCE CENTER
         Approved: 03/14/2003
         Terminated: 12/01/2005
     IN TRAINING COLLEGE OF ADULT EDUCATION
         Approved: 12/01/1997
         Terminated: 12/01/2005
     MERIDIAN HEALTH CARE (I), INC
         Approved: 06/30/1997
         Terminated: 12/01/2005
     LINCOLNSHIRE HEALTH & REHABILITATION CENTER
         Approved: 04/04/2000
         Terminated: 08/21/2013
     OLYMPIA COLLEGE
         Approved: N/A
         Terminated: 12/01/2005
     IVY TECH STATE COLLEGE NORTHWEST
         Approved: 04/09/1997
         Terminated: 12/01/2005
     1ST IN CLASS CLINICAL EDUCATION
         Approved: 11/21/2017
         Terminated: N/A
 


Complaints

NUMBER OF SUBSTANTIATED COMPLAINTS: 
 
  Current year:  4
  Previous year:  1
  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
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: IKGN11
  Action - Citation / Fine
  Notice to facility: 06/01/2004
             Appeal: N/A
  Action Cease/Recind: 12/19/2004
         Case Closed: 12/19/2004
  Initial Amount: $5000
Event ID: TW1G11
  Action - Citation / Fine
  Notice to facility: 05/14/2001
             Appeal: 06/05/2001
  Action Cease/Recind: 09/24/2003
         Case Closed: 09/24/2003
  Initial Amount: $3750
 
Federal Certification Actions Imposed
 
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

FKDG12
Complaint, Follow Up
05/10/2018


WP9W12
Complaint, Follow Up
05/10/2018


GTIH11
Complaint
05/01/2018


WP9W11
Complaint
04/25/2018


FKDG11
Complaint
03/28/2018


HN4L11
Complaint
02/20/2018


IVPV12
Complaint, Follow Up
02/08/2018


ZCZS22
Recertification, Follow Up, Life Safety Code
02/06/2018


ZCZS21
Recertification, Life Safety Code
01/17/2018


IVPV11
Complaint
01/17/2018


ZCZS12
Recertification, Follow Up, State Licensure
01/16/2018


ZCZS11
Recertification, State Licensure
12/11/2017


XRDD11
Complaint
06/19/2017


OAL812
Complaint, Follow Up
04/21/2017


OAL811
Complaint
03/31/2017


75IM22
Follow Up, Life Safety Code, Recertification
01/25/2017


75IM12
Recertification, Follow Up, State Licensure
12/21/2016


3FXC11
Complaint
12/14/2016


75IM21
Recertification, Life Safety Code
11/28/2016


75IM11
Recertification, Complaint, State Licensure
10/28/2016


RF7511
Complaint
07/18/2016


44L011
Complaint
07/01/2016


LWU211
Complaint
06/17/2016


WRKJ22
Follow Up, Life Safety Code, Recertification
01/06/2016


2IRM11
Complaint
12/08/2015


72UW12
Complaint, Follow Up
10/29/2015


WRKJ12
Recertification, Follow Up, State Licensure
10/29/2015


WRKJ21
Life Safety Code, Recertification
10/14/2015


72UW11
Complaint
10/08/2015


WRKJ11
Recertification, State Licensure
10/02/2015


J60W11
Complaint
09/10/2015


 
 


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.