SKILLED NURSING FACILITY / NURSING FACILITY DISTINCT PART
Created on: 3/8/2024
Posted to the Web on: 3/20/2024
Basic Information
FACILITY CONTACT INFORMATION:
Address: 628 N MERIDIAN RD
City: GREENFIELD
Telephone: (317) 462-7067
Web Site:
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
LICENSE INFORMATION:
License number: 23-005954-2
License effective date: 11/1/2023
License expiration date: 10/31/2024
Administration and Staff
Administrator: KEITH WILSON
Start date: 2/17/2024
Director of Nursing: NATALIE JEAN WOODWARD
Start date: 5/14/2023
Medical director: James Brinkruff
Start date: / /
Wound care specialist:
Start date: / /
Infection preventionist:
Start date: / /
Ownership
CURENT OWNERSHIP:
Owning corporation: HANCOCK REGIONAL HOSPITAL
801 NORTH STATE STREET
GREENFIELD IN 46140
Ownership type: OTHER
Officer(s): TIMOTHY CLARK
ROY WILSON
DEAN FELKER
STEVEN LONG
SARA JOYNER
JOSH DAUGHERTY
MARIA BOND
LACEY WILLARD
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: TRILOGY HEALTH SERVICES LLC
Date of last change of ownership: 11/1/2014
Bed Counts and Census
COMPREHENSIVE CARE BEDS:
Number of Medicaid beds (NF): 0
Number of Medicare beds (SNF): 34
Number of Medicare/Medicaid beds (SNF/NF): 40
Number of non-certified comprehensive care beds (State Licensed only): 0
Total number of comprehensive care beds: 74
RESIDENTIAL CARE BEDS:
Total number of residential beds: 86
Total number of beds in facility: 160
CENSUS:
Facility census: 111
As reported by the facility on: 1/15/2024
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 1/15/2024
Residential care beds occupied: 53
As reported by the facility on: 1/15/2024
Alzheimer Beds: 35
Alzheimer Beds Occupied: 33
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: 47
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: 47
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 - JAMES JOHNSON
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. DIRECTOR OF PLANT OP
Date form completed - 3/31/2022
Nurse Aide Training
NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 7/21/2023
Nurse aide training and competency evaluation program (NATCEP) expires: 4/1/2025
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:
PRIMEWAY INSTITUTE
Approved: 11/12/2010
Terminated: 6/14/2021
NEW CASTLE CAREER CENTER
Approved: 7/31/2019
Terminated: N/A
CERTIFIED HEALTHCARE TRAINING
Approved: 2/20/2019
Terminated: N/A
DISTRICT 26 CAREER CAMPUS
Approved: 8/20/2020
Terminated: N/A
HARDON EDUCATION
Approved: 10/1/2021
Terminated: N/A
BLUE RIVER CAREER PROGRAMS
Approved: 6/10/2022
Terminated: N/A
LEFFLER ACADEMY, LLC
Approved: 7/26/2022
Terminated: N/A
WALKER CAREER CENTER
Approved: 11/1/2023
Terminated: N/A
SPRINGHURST HEALTH CAMPUS
Approved: 7/21/2023
Terminated: N/A
CLEARVISTA LAKE HEALTH CAMPUS
Approved: 10/31/2023
Terminated: N/A
Complaints
NUMBER OF SUBSTANTIATED COMPLAINTS:
Current year: 0
Previous year: 0
2 years previous: 1
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
435
435
435
411
Rank of Score
13
12
12
24
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 gridView 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
Yes
Yes
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
Event ID: TXT711
Action - Citation / Fine
Notice to facility: 9/19/2022
Appeal: N/A
Action Cease/Recind: 9/28/2022
Case Closed: 9/28/2022
Initial Amount: $2500
Federal Certification Actions Imposed
Directed Plan of Correction
Date Imposed: 3/18/2023 Date Ended: 4/1/2023
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.
