Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
ALPHA HOME - A WATERS COMMUNITY
 
NURSING HOME
SKILLED NURSING FACILITY / NURSING FACILITY DUALLY CERTIFIED
Created on: 3/8/2024
 
Posted to the Web on: 3/20/2024
 
 



Basic Information

FACILITY CONTACT INFORMATION:
Address: 2640 COLD SPRING RD
City: INDIANAPOLIS
Telephone: (317) 923-1518
Web Site:  
 
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
 
LICENSE INFORMATION:
  License number: 23-000376-1
  License effective date: 10/1/2023
  License expiration date: 9/30/2024
 


Administration and Staff

Administrator: EVELYN M LAWS
  Start date: 9/18/2023
 
Director of Nursing: TONYA L STRONG
  Start date: 8/6/2023
 
Medical director:  
  Start date:   /  /  
 
Wound care specialist:  
  Start date:   /  /  
 
Infection preventionist:  
  Start date:   /  /  
 


Ownership

CURENT OWNERSHIP:
 
Owning corporation: HENRY COUNTY MEMORIAL HOSPITAL
798 NORTH 16TH ST
NEW CASTLE IN 47362
 
Ownership type:  NON-PROFIT
 
Officer(s): STEVEN VAN CAMP
            JOHN PIDGEON
            SHELDON DYNES
            PAUL JANSSEN
            BENJAMIN FRENCH
            DEBI WARE
            BUD SHORE
            DARIN BROWN
            BRIANNA CHAPMAN
            SCOTT KOONTZ
            KYLE SIEWERT
            DUKE HAMM
            JANA LUELLEN
            TODD MYERS
            BRENDA WILKINSON
            NATHAN RICH
            DEBBIE MARGISON
            JOSH ESTELLE
            WYLIE MCGLOTHLIN
            JOEL HARVEY
            DAVE WEIMER
            VANESSA TUCKER
            BRIAN RING
 
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: DEARBORN COUNTY HOSPITAL
Date of last change of ownership: 10/1/2020
 


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):        86
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     86
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            0
 
Total number of beds in facility:            86
 
CENSUS:
Facility census:  58
As reported by the facility on: 7/7/2023 1
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 7/7/2023 1
 
Residential care beds occupied:  0
As reported by the facility on: 7/7/2023 1
 
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: 37
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: 37
 
  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 - JOHN D FAULKNER
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. MAINTENANCE DIR
Date form completed - 3/12/2021
 


Nurse Aide Training

NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved:  
Nurse aide training and competency evaluation program (NATCEP) expires:  
Nurse aide training and competency evaluation program (NATCEP) banned: Yes
Nurse aide training and competency evaluation program (NATCEP) ban expires: 4/12/2024
 
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: 
     IVY TECH COMMUNITY COLLEGE
         Approved: 6/14/2000
         Terminated: 8/20/2008
     AMBASSADOR COMMUNITY COLLEGE
         Approved: N/A
         Terminated: 12/2/2005
     PRIMEWAY INSTITUTE
         Approved: 6/23/2011
         Terminated: 7/13/2012
     AMBASSADOR COMMUNITY COLLEGE
         Approved: N/A
         Terminated: 12/2/2005
 


Complaints

NUMBER OF SUBSTANTIATED COMPLAINTS: 
 
  Current year:  0
  Previous year:  0
  2 years previous:  3

 


Facility Report Card



 


 
3/1/2020 Current QTR
12/1/2019 Previous QTR
9/1/2019 Previous QTR
6/1/2019 Previous QTR


Report Card Score
159
183
213
216


Rank of Score
94
91
88
89


Average Score
302
296
295
296


 
*Facility report card scores have not been updated since March 1, 2020 due to changes in the survey process during the ongoing COVID-19 pandemic. 
The facility report card score is calculated four times per calendar year 
for the two most recent nursing home health surveys.  The facility report card score 
also includes all complaint surveys, life safety code surveys, emergency preparedness surveys, 
and any follow-up surveys that occur within the two most recent nursing home health surveys. 
The facility report card score ranges from 500 to 0, with 500 being the best score possible. 
 
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
Yes
No


 Substandard Quality of Care 
No
Yes
No


Administrator Change
Yes
Yes
Yes


Owner Change
No
Yes
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

 
Federal Certification Actions Imposed
     Discretionary Deny Pay for New Admits
     Date Imposed: 5/14/2022  Date Ended: 7/6/2022
     Directed Plan of Correction
     Date Imposed: 5/14/2022  Date Ended: 7/7/2022
     Civil Money Penalty
     Date Imposed: 3/18/2022  Date Ended: 7/6/2022
     Amount proposed per day: 8430
     Amount proposed per day: 440
     Amount proposed per day: 550
     Directed Plan of Correction
     Date Imposed: 2/10/2022  Date Ended: 2/1/2022
     Directed Plan of Correction
     Date Imposed: 1/18/2022  Date Ended: 2/1/2022
     Civil Money Penalty
     Date Imposed: 12/16/2021  Date Ended: 1/12/2022
     Amount proposed per day: 
     Amount proposed per day: 
     Directed Plan of Correction
     Date Imposed: 10/27/2021  Date Ended: 10/27/2021
     Civil Money Penalty
     Date Imposed: 9/28/2021  Date Ended: 9/28/2021
     Amount proposed per day: 
     Directed Plan of Correction
     Date Imposed: 7/9/2021  Date Ended: 7/7/2021
     Civil Money Penalty
     Date Imposed: 5/5/2021  Date Ended: 7/6/2021
     Amount proposed per day: 
     Amount proposed per day: 435
     Amount proposed per day: 6920
     Civil Money Penalty
     Date Imposed: 4/5/2021  Date Ended: 4/5/2021
     Amount proposed per day: 1500
 
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

0HDC11
Complaint
1/31/2024


6QWE22
Recertification, Follow Up, Life Safety Code
10/25/2023


6QWE12
Recertification, Follow Up, State Licensure
9/14/2023


6QWE21
Recertification, Life Safety Code
8/30/2023


6QWE11
Recertification, Complaint, State Licensure
8/11/2023


6FZL11
Complaint
6/15/2023


QRRL11
Complaint
3/23/2023


SILU11
Complaint
10/31/2022


V9S713
Recertification, Follow Up, State Licensure
8/2/2022


V9S722
Recertification, Follow Up, Life Safety Code
7/11/2022


UOX612
Complaint, Follow Up, Other
6/7/2022


V9S712
Recertification, Complaint, Follow Up, State Licensure
6/7/2022


XKY611
Complaint
5/26/2022


V9S721
Recertification, Life Safety Code
5/12/2022


V9S711
Recertification, Complaint, State Licensure
4/13/2022


UOX611
Complaint, Other
3/2/2022


BIOG12
Complaint, Follow Up, Other
2/9/2022


XWL711
Complaint
2/9/2022


YB3K12
Complaint, Follow Up, Other
2/9/2022


NNHV11
Complaint, Other
1/24/2022


BIOG11
Complaint, Other
1/12/2022


YB3K11
Complaint, Other
12/16/2021


9XEH12
Complaint, Follow Up
11/12/2021


1B5G11
Other
10/28/2021


9XEH11
Complaint, Other
9/28/2021


Z8WB11
Complaint
9/1/2021


OHLX12
Complaint, Follow Up, Other
7/23/2021


ECJM12
Complaint, Follow Up
7/23/2021


OHLX11
Complaint, Other
6/12/2021


ECJM11
Complaint
4/23/2021


 
 


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.