Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
WESTSIDE RETIREMENT VILLAGE
 
NURSING HOME
SKILLED NURSING FACILITY / NURSING FACILITY DUALLY CERTIFIED
Created on: 07/25/2025
 
Posted to the Web on: 08/06/2025
 
 



Basic Information

FACILITY CONTACT INFORMATION:
Address: 8616 W 10TH ST
City: INDIANAPOLIS
Telephone: (317) 209-2800
Web Site:  
 
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
 
LICENSE INFORMATION:
  License number: 24-000497-1
  License effective date: 08/01/2024
  License expiration date: 07/31/2025
 


Administration and Staff

Administrator: TAMELA JONES
  Start date: 04/09/2025
 
Director of Nursing: HEATHER RICHARDSON
  Start date: 08/07/2023
 
Medical director:  
  Start date:   /  /  
 
Wound care specialist:  
  Start date:   /  /  
 
Infection preventionist:  
  Start date:   /  /  
 


Ownership

CURENT OWNERSHIP:
 
Owning corporation: HENDRICKS COUNTY HOSPITAL
1000 EAST MAIN STREET
DANVILLE IN 46122
 
Ownership type:  NON-PROFIT
 
Officer(s): KEVIN SPEER
            ERIN ENGELS
            TODD DAVIS
            YVONNE CULPEPPER
            D. MICHELLE FENOUGHTY
            STANTON "STAN" RISSER
            LISA IMLAY
            GARY EVERLING
            MICHAEL KIRSCHNER
            TYLER STARKEY
            JOHN WAITE
            MARK GENTRY
            TIM WHICKER
            SHANE SOMMERS
            NANCY FOSTER
            RYAN VAN DONSELAA
            WESLEY ROGERS
 
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: WESTSIDE LIMITED PARTNERSHIP
Date of last change of ownership: 08/01/2018
 


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):        132
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     132
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            0
 
Total number of beds in facility:            132
 
CENSUS:
Facility census:  102
As reported by the facility on: 06/16/2024
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 06/16/2024
 
Residential care beds occupied:  0
As reported by the facility on: 06/16/2024
 
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:  
 
Number of comprehensive care resident rooms: 132
Number of comprehensive care resident rooms with battery 
                    operated smoke detectors: 132
Number of comprehensive care resident rooms 
             with hard wired and/or wireless smoke detectors: 132
 
  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 - GILBERT MATTEUCCI
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. MAINTENACE DIRECTOR
Date form completed - 04/04/2025
 


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: 01/07/2023
 
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: 
     LTC NURSING SERVICES, PC
         Approved: 03/18/2002
         Terminated: 11/26/2019
     AREA 31 CAREER CENTER
         Approved: 11/30/1998
         Terminated: 11/26/2019
     WESTSIDE RETIREMENT VILLAGE
         Approved: N/A
         Terminated: 11/26/2019
     VINCENNES UNIVERSITY JASPER CAMPUS
         Approved: 02/25/2013
         Terminated: 11/26/2019
     MEDTECH COLLEGE-INDIANAPOLIS CAMPUS
         Approved: 10/18/2013
         Terminated: 04/01/2018
     INDYSTATHEALTHEDU, LLC
         Approved: 06/08/2016
         Terminated: 11/26/2019
     THE ATATJ INSTITUTE LLC
         Approved: 04/29/2025
         Terminated: N/A
     ELITE CAREER INSTITUTE
         Approved: 12/13/2024
         Terminated: N/A
 


Complaints

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

 


Facility Report Card



 


 
03/01/2020 Current QTR
12/01/2019 Previous QTR
09/01/2019 Previous QTR
06/01/2019 Previous QTR


Report Card Score
268
301
318
321


Rank of Score
79
71
64
63


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
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

 
Federal Certification Actions Imposed
     Directed Plan of Correction
     Date Imposed: 10/08/2022  Date Ended: 10/01/2022
     Civil Money Penalty
     Date Imposed: 09/01/2022  Date Ended: 09/01/2022
     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.


 
Event ID
Survey Type
Exit Date

GL9Q12
Complaint, Follow Up
07/08/2025


GL9Q11
Complaint
05/21/2025


ZFVR22
Follow Up, Life Safety Code, Recertification
04/03/2025


ZFVR12
Recertification, Complaint, Follow Up, State Licensure
03/27/2025


ZFVR21
Recertification, Life Safety Code
02/10/2025


ZFVR11
Recertification, Complaint, State Licensure
01/15/2025


W3OW12
Complaint, Follow Up
01/13/2025


W3OW11
Complaint
11/07/2024


QZ0012
Complaint, Follow Up
09/24/2024


6DY912
Complaint, Follow Up
08/27/2024


QZ0011
Complaint
08/16/2024


6DY911
Complaint
06/28/2024


VJPU12
Complaint, Follow Up
06/14/2024


QB2Q11
Complaint
05/09/2024


VJPU11
Complaint
04/17/2024


PLXR22
Recertification, Follow Up, Life Safety Code
02/23/2024


PLXR12
Recertification, Complaint, Follow Up, State Licensure
01/29/2024


PLXR21
Recertification, Life Safety Code
01/02/2024


PLXR11
Recertification, Complaint, State Licensure
12/04/2023


LTDM12
Complaint, Follow Up
11/17/2023


LTDM11
Complaint
10/12/2023


CUHF12
Complaint, Follow Up
05/09/2023


CUHF11
Complaint, Other
04/11/2023


ZVLH11
Complaint
03/15/2023


4L7211
Complaint
03/02/2023


OKEJ22
Recertification, Follow Up, Life Safety Code
11/30/2022


OKEJ12
Recertification, Complaint, Follow Up, State Licensure
11/29/2022


OKEJ21
Recertification, Life Safety Code
10/05/2022


OKEJ11
Recertification, Complaint, State Licensure
09/01/2022


 
 


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.