Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
FAIRWAY 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: 2630 S KEYSTONE AVE
City: INDIANAPOLIS
Telephone: (317) 787-8951
Web Site:  
 
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
 
LICENSE INFORMATION:
  License number: 24-004700-2
  License effective date: 08/01/2024
  License expiration date: 07/31/2025
 


Administration and Staff

Administrator: PATRICK NGENE
  Start date: 03/06/2023
 
Director of Nursing: DANIEL BAU
  Start date: 11/07/2021
 
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:  PROFIT
 
Officer(s): JOHN PIDGEON
            SHELDON DYNES
            DEBI WARE
            BUD SHORE
            BRIAN RING
            MARK DICE
            DAVID BARR
 
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY
Date of last change of ownership: 08/01/2024
 


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):        53
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     53
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            0
 
Total number of beds in facility:            53
 
CENSUS:
Facility census:  36
As reported by the facility on: 01/11/2022
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 01/11/2022
 
Residential care beds occupied:  0
As reported by the facility on: 01/11/2022
 
Alzheimer Beds:  53
Alzheimer Beds Occupied:  34
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: 49
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: 45
 
  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 - PATRICK NGENE
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. EXECUTIVE DIRECTOR
Date form completed - 09/04/2019
 


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: 04/16/2020
 
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: 
     PRIMEWAY INSTITUTE
         Approved: 03/23/2006
         Terminated: 04/29/2009
     ASC TRAINING CENTER
         Approved: 07/28/2020
         Terminated: N/A
     HEALTHCARE CAREER TRAINING INSTITUTE
         Approved: 07/07/2016
         Terminated: 04/17/2018
     LEFFLER ACADEMY
         Approved: 05/10/2021
         Terminated: N/A
     INDY INSTITUTE
         Approved: 05/21/2024
         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
379
409
415
415


Rank of Score
38
23
21
22


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
No
No
Yes


Owner Change
No
No
No


Number of Substantiated Complaints With Deficiencies
0
0
0


Deficiency Free Standard Health Survey
Yes
Yes
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
 
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

VY6N22
Follow Up, Life Safety Code, Recertification
04/30/2025


VY6N21
Recertification, Life Safety Code
03/13/2025


VY6N11
Recertification, Complaint, State Licensure
02/26/2025


H2WM11
Complaint
12/06/2024


UGD622
Follow Up, Life Safety Code, Recertification
07/26/2024


UGD621
Recertification, Life Safety Code
05/28/2024


UGD611
Recertification, State Licensure
05/01/2024


C1TU11
Complaint
11/06/2023


BYZF11
Complaint
10/13/2023


6F7Z22
Follow Up, Life Safety Code, Recertification
10/12/2023


6F7Z12
Recertification, Follow Up, State Licensure
08/28/2023


6F7Z21
Recertification, Life Safety Code
08/15/2023


6F7Z11
Recertification, State Licensure
07/24/2023


HUT911
Complaint
03/30/2023


3XJV22
Recertification, Follow Up, Life Safety Code
12/13/2022


3XJV21
Recertification, Life Safety Code
10/19/2022


3XJV11
Recertification, State Licensure
09/16/2022


0Q9T12
Complaint, Follow Up
09/07/2022


0Q9T11
Complaint
07/28/2022


 
 


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.