Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
CREEKSIDE HEALTH AND REHABILITATION CENTER
 
NURSING HOME
SKILLED NURSING FACILITY / NURSING FACILITY DUALLY CERTIFIED
Created on: 3/8/2024
 
Posted to the Web on: 3/20/2024
 
 



Basic Information

FACILITY CONTACT INFORMATION:
Address: 3114 EAST 46TH STREET
City: INDIANAPOLIS
Telephone: (317) 920-7888
Web Site:  
 
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
 
LICENSE INFORMATION:
  License number: 23-009569-1
  License effective date: 8/1/2023
  License expiration date: 7/31/2024
 


Administration and Staff

Administrator: STACIA DAWSON
  Start date: 1/3/2022
 
Director of Nursing: KYRA COOKE
  Start date: 9/13/2021
 
Medical director: Mohammad Yassin-Kassab
  Start date:   /  /  
 
Wound care specialist: Charnicka Williams
  Start date:   /  /  
 
Infection preventionist: LaDonna Lewis
  Start date:   /  /  
 


Ownership

CURENT OWNERSHIP:
 
Owning corporation: RIVERVIEW HOSPITAL
395 WESTFIELD ROAD
NOBLESVILLE IN 46060
 
Ownership type:  NON-PROFIT
 
Officer(s): WILLIAM KIRSCH
            GREG MURRAY
            LEEANN MURRAY
            CHARLES MULRY
            SAM MISHELOW
            MICHAEL DAUGHERTY
            JAYNA L FRIEND
            DAVE HYATT
            DAN STEVENS
 
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: BRIARWOOD HEALTHCARE OPERATIONS COMPANY
Date of last change of ownership:  
 


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):        120
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     120
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            0
 
Total number of beds in facility:            120
 
CENSUS:
Facility census:  111
As reported by the facility on: 1/2/2024 9
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 1/2/2024 9
 
Residential care beds occupied:  0
As reported by the facility on: 1/2/2024 9
 
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: 116
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: 116
 
  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 - STACIA DAWSON
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. EXEC DIR
Date form completed - 3/24/2023
 


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: 6/17/2023
 
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: 
     INDIANA HOME HEALTH CAREER CENTER
         Approved: 10/28/2008
         Terminated: 8/4/2014
     PRIMEWAY INSTITUTE
         Approved: 12/10/2008
         Terminated: 8/4/2014
     PINNACLE LEARNING CENTER
         Approved: 4/30/2002
         Terminated: 8/4/2014
     PRO-VISION TRAINING SERVICES
         Approved: 7/17/2014
         Terminated: 8/4/2014
     AMBASSADOR CAREER CENTER
         Approved: 3/3/2005
         Terminated: 8/4/2014
     AMBASSADOR INSTITUTE OF INDIANA
         Approved: 11/30/1999
         Terminated: 8/4/2014
     DAY SPRING CAREER INSTITUTE
         Approved: 6/12/2009
         Terminated: 8/4/2014
     NURSE AIDE TRAINING CENTER LLC
         Approved: 5/5/1999
         Terminated: 8/4/2014
     CNA & HOMECARE TRAINING CENTER, INC
         Approved: 1/2/2013
         Terminated: 8/4/2014
     RISE UP HEALTH CARE ACADEMY
         Approved: 5/25/2017
         Terminated: 6/18/2021
     AVONDALE MEADOWS YMCA OF GREATER INDIANAPOLIS
         Approved: 3/16/2022
         Terminated: 6/18/2021
     AVONDALE MEADOWS YMCA OF GREATER INDIANAPOLIS
         Approved: 3/16/2021
         Terminated: 6/18/2021
     RISE UP HEALTH CARE ACADEMY
         Approved: 1/16/2024
         Terminated: N/A
 


Complaints

NUMBER OF SUBSTANTIATED COMPLAINTS: 
 
  Current year:  0
  Previous year:  0
  2 years previous:  7

 


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
219
156
198
219


Rank of Score
88
94
90
88


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
Yes
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
     Civil Money Penalty
     Date Imposed: 5/9/2022  Date Ended: 5/24/2022
     Amount proposed per day: 1065
     Directed Plan of Correction
     Date Imposed: 12/31/2021  Date Ended: 12/28/2021
     Civil Money Penalty
     Date Imposed: 12/6/2021  Date Ended: 12/6/2021
     Amount proposed per day: 
     Directed Plan of Correction
     Date Imposed: 9/28/2021  Date Ended: 9/21/2021
     Civil Money Penalty
     Date Imposed: 9/3/2021  Date Ended: 9/3/2021
     Amount proposed per day: 
     Directed Plan of Correction
     Date Imposed: 6/18/2021  Date Ended: 7/28/2021
     Discretionary Deny Pay for New Admits
     Date Imposed: 6/18/2021  Date Ended: 7/27/2021
     Civil Money Penalty
     Date Imposed: 5/19/2021  Date Ended: 6/16/2021
     Amount proposed per day: 600
     Amount proposed per day: 
     Amount proposed per day: 600
     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

SYI911
Complaint
2/10/2024


2TJS11
Complaint
1/23/2024


MEXC22
Follow Up, Life Safety Code, Recertification
1/17/2024


MEXC12
Recertification, Complaint, Follow Up, State Licensure
1/11/2024


MEXC21
Recertification, Life Safety Code
12/15/2023


MEXC11
Recertification, Complaint, State Licensure
12/5/2023


BQCY11
Complaint
12/5/2023


Z0RG11
Complaint
6/21/2023


5FRO11
Complaint
4/25/2023


VPRQ12
Complaint, Follow Up, Other
4/24/2023


VPRQ11
Complaint, Other
3/14/2023


Q1U022
Recertification, Follow Up, Life Safety Code
10/5/2022


Q1U013
Recertification, Follow Up, State Licensure
10/5/2022


Q1U012
Recertification, Complaint, Follow Up, State Licensure
9/20/2022


Q1U021
Recertification, Life Safety Code
9/19/2022


Q1U011
Recertification, Complaint, State Licensure
8/9/2022


R9RL12
Complaint, Follow Up
7/22/2022


R9RL11
Complaint
6/29/2022


4JLB12
Complaint, Follow Up
6/3/2022


1MHW12
Complaint, Follow Up
6/3/2022


4JLB11
Complaint
5/10/2022


1MHW11
Complaint, Other
4/27/2022


F9PS12
Complaint, Follow Up, Other
2/10/2022


WIJB12
Complaint, Follow Up
2/10/2022


OS3R11
Complaint
2/7/2022


F9PS11
Complaint, Other
1/13/2022


WIJB11
Complaint
1/11/2022


9F8K12
Follow Up, Other
1/7/2022


FMBT11
Complaint, Other
12/28/2021


9F8K11
Other
12/6/2021


CFZ312
Complaint, Follow Up
11/2/2021


CFZ311
Complaint
10/5/2021


T2R312
Complaint, Follow Up, Other
9/30/2021


T2R311
Complaint, Other
9/3/2021


ETBD12
Complaint, Follow Up
8/6/2021


S4IY12
Recertification, Complaint, Follow Up, State Licensure
8/6/2021


WQ4X12
Complaint, Follow Up
8/6/2021


S4IY22
Recertification, Follow Up, Life Safety Code
7/22/2021


WQ4X11
Complaint
7/15/2021


TNDI11
Complaint
6/29/2021


ETBD11
Complaint
6/16/2021


S4IY21
Recertification, Life Safety Code
6/8/2021


S4IY11
Recertification, Complaint, State Licensure
5/19/2021


UR4D12
Complaint, Follow Up
4/8/2021


 
 


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.