Indiana State Department of Health

Division of Long Term Care

CONSUMER REPORT

WORTHINGTON PLACE

NURSING HOME

RESIDENTIAL FACILITY

Created on: 1/13/2023

Posted to the Web on: 1/25/2023
Basic Information
FACILITY CONTACT INFORMATION: Address: 10799 ALLIANCE DR City: CAMBY Telephone: (317) 856-6224 Web Site: NAME CHANGES: Most recent name change: N/A Date of most recent name change: N/A LICENSE INFORMATION: License number: 22-003984-1 License effective date: 7/1/2022 License expiration date: 6/30/2023
Administration and Staff
Administrator: SHERYL MORNING Start date: 10/22/2012 Director of Nursing: LISA O'CONNOR Start date: 3/1/2021 Medical director: Start date: / / Wound care specialist: Start date: / / Infection preventionist: Start date: / /
Ownership
CURENT OWNERSHIP: Owning corporation: WORTHINGTON AID OPCO LLC 301 COMMERCE STREET, STE 3300 FORT WORTH TX 76102 Ownership type: PROFIT Officer(s): DANIEL MARSHALL GUILL ERICH REUTZEL PETER C SMITH PREVIOUS OWNERSHIP CHANGES: Name of previous owner: ASSISTED LIVING CONCEPTS INC Date of last change of ownership: 7/11/2013
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): 0 Number of non-certified comprehensive care beds (State Licensed only): 0 Total number of comprehensive care beds: 0 RESIDENTIAL CARE BEDS: Total number of residential beds: 47 Total number of beds in facility: 47 CENSUS: Facility census: 25 As reported by the facility on: 1/5/2023 1 Number of comprehensive care beds occupied in this facility. 0 As reported by the facility on: 1/5/2023 1 Residential care beds occupied: 25 As reported by the facility on: 1/5/2023 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: / /
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: No Nurse aide training and competency evaluation program (NATCEP) ban expires: N/A CLINICAL TRAINING SITES: This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites:
Complaints
NUMBER OF SUBSTANTIATED COMPLAINTS: 
 
  Current year:  0
  Previous year:  0
  2 years previous:  0
State Licensure Surveys
The ISDH conducts a state licensure survey at each licensed residential facility
approximately once per year.  If state findings are cited on a survey, the
residential facility may be requested by the ISDH to complete a plan of
correction on how and when they will correct each state finding and who will be
responsible to ensure the corrections are made and will not reoccur in the future.
The plan of correction is generally submitted by the residential facility and
reviewed by the ISDH within fifteen (15) days of the survey.

To read an overview of the survey process, click here
   
NOTE:
    The residential consumer report survey information begins with surveys that
    have been completed on or after December 1, 2008.  Any survey performed prior
    to that date will not have any information in the state findings count rows or
    columns or will show zero.
8/31/2021 Most Recent 3/3/2020 2nd Most Recent 1/11/2019 3rd Most Recent
Number of state findings 0 1 0
State Average for the year of the survey (rounded to nearest whole integer). 4 3 3
Survey Report View Survey Report View Survey Report View Survey Report
Enforcement Actions
Event ID: ZY7X11 Action - Citation / Fine Notice to facility: N/A Appeal: N/A Action Cease/Recind: N/A Case Closed: 6/13/2022 Initial Amount: $7500
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
XJDJ11 Complaint 8/15/2022
P9N111 Complaint 6/14/2022
ZY7X12 Complaint, Follow Up 4/8/2022
ZY7X11 Complaint 2/22/2022
FU5711 Relicensure 8/31/2021
VO1N12 Complaint, Follow Up 8/26/2021
VO1N11 Complaint 7/21/2021
ZPR011 Other 1/7/2021
C7PQ11 Relicensure 3/3/2020
 
 
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.