Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
MEADOW LAKES
 
NURSING HOME
SKILLED NURSING FACILITY / NURSING FACILITY DISTINCT PART
Created on: 07/25/2025
 
Posted to the Web on: 08/06/2025
 
 



Basic Information

FACILITY CONTACT INFORMATION:
Address: 200 MEADOW LAKE DR
City: MOORESVILLE
Telephone: (317) 834-1791
Web Site:  
 
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
 
LICENSE INFORMATION:
  License number: 25-004831-1
  License effective date: 02/01/2025
  License expiration date: 01/31/2026
 


Administration and Staff

Administrator: WILLIAM MCCALLUM
  Start date: 11/07/2024
 
Director of Nursing: MARIA NEWKIRK
  Start date: 10/08/2021
 
Medical director: Daniel hurley
  Start date:   /  /  
 
Wound care specialist:  
  Start date:   /  /  
 
Infection preventionist:  
  Start date:   /  /  
 


Ownership

CURENT OWNERSHIP:
 
Owning corporation: HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY
3838 N RURAL ST
INDIANAPOLIS IN 46205
 
Ownership type:  OTHER
 
Officer(s): GREGORY FEHRIBACH
            CHARLES EBERHARDT II
            CARL DRUMMER
            SHELIA GUENIN
            TED NOLTING
            PAUL BABCOCK
            ROBERT LAZARD
            GEETA MANTRAVADI
            MONICA CRAIN
            BEVERLY MUKES-GAITHER
            THOMAS HANIFY
            LISA HARRIS
            DAVID CRABB
            ROBERTY LAZARD
            BRENDA HORN
 
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: MEADOW LAKE OF MOORESVILLE LLC
Date of last change of ownership: 02/01/2009
 


Bed Counts and Census

COMPREHENSIVE CARE BEDS:
Number of Medicaid beds (NF):                     0
Number of Medicare beds (SNF):                    26
Number of Medicare/Medicaid beds (SNF/NF):        111
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     137
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            70
 
Total number of beds in facility:            207
 
CENSUS:
Facility census:  166
As reported by the facility on: 12/12/2022
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 12/12/2022
 
Residential care beds occupied:  49
As reported by the facility on: 12/12/2022
 
Alzheimer Beds:  26
Alzheimer Beds Occupied:  26
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: 69
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: 69
 
  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 - MAC MCCALLUM
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. ADMINISTRATOR
Date form completed - 04/04/2025
 


Nurse Aide Training

NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 06/20/2018
Nurse aide training and competency evaluation program (NATCEP) expires: 04/01/2020
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: 
     NURSE AIDE TRAINING CENTER LLC
         Approved: 02/22/2008
         Terminated: N/A
     AREA 31 CAREER CENTER
         Approved: 03/25/2008
         Terminated: N/A
     ASC TRAINING CENTER
         Approved: 01/23/2017
         Terminated: N/A
     MEADOW LAKES
         Approved: 06/20/2018
         Terminated: N/A
     LEFFLER ACADEMY
         Approved: 05/10/2021
         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
345
303
309
333


Rank of Score
53
70
67
58


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
Yes


Owner Change
No
No
No


Number of Substantiated Complaints With Deficiencies
0
0
0


Deficiency Free Standard Health Survey
No
No
Yes


 
    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: FCN611
  Action - Citation / Fine
  Notice to facility: 04/05/2023
             Appeal: N/A
  Action Cease/Recind: 04/21/2023
         Case Closed: 04/21/2023
  Initial Amount: $5000
 
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

VQ7H22
Follow Up, Life Safety Code, Recertification
05/15/2025


IZW511
Complaint
05/13/2025


NGW211
Complaint
04/29/2025


VQ7H12
Recertification, Follow Up, State Licensure
04/21/2025


VQ7H21
Recertification, Life Safety Code
04/01/2025


VQ7H11
Recertification, Complaint, State Licensure
03/18/2025


VENW11
Complaint
01/29/2025


IUZD12
Complaint, Follow Up
01/06/2025


IUZD11
Complaint
12/12/2024


GXC811
Complaint
11/01/2024


PSMX11
Complaint
09/10/2024


4S4Z11
Complaint
08/30/2024


5TEL11
Complaint
07/29/2024


GZPV22
Recertification, Follow Up, Life Safety Code
07/22/2024


GZPV12
Recertification, Follow Up, State Licensure
07/02/2024


GZPV21
Recertification, Life Safety Code
06/27/2024


GZPV11
Recertification, State Licensure
06/05/2024


XDTB11
Complaint
03/20/2024


2Q4R12
Complaint, Follow Up
02/13/2024


FV8H11
Complaint
02/13/2024


2Q4R11
Complaint
01/10/2024


UKI211
Complaint
12/11/2023


VOMG11
Complaint
10/27/2023


1UWS11
Complaint
10/12/2023


OGXF11
Complaint, Other
08/30/2023


PSWX11
Complaint
08/17/2023


C0QP11
Complaint
08/09/2023


2KHU11
Complaint
07/21/2023


04DX22
Recertification, Follow Up, Life Safety Code
07/07/2023


04DX21
Recertification, Life Safety Code
06/12/2023


04DX11
Recertification, Complaint, State Licensure
06/02/2023


6P5X11
Complaint
03/08/2023


FCN612
Complaint, Follow Up
02/06/2023


FCN611
Complaint
01/04/2023


BD6922
Recertification, Follow Up, Life Safety Code
10/12/2022


9TST11
Complaint
09/29/2022


BD6912
Recertification, Follow Up, State Licensure
09/23/2022


BD6921
Recertification, Life Safety Code
09/15/2022


BD6911
Recertification, State Licensure
08/22/2022


 
 


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.