Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
 
THIS FACILITY HAS CLOSED
 
EAGLE CREEK HEALTHCARE CENTER
 
NURSING HOME
SKILLED NURSING FACILITY / NURSING FACILITY DUALLY CERTIFIED
Created on: 11/19/2021
 
Posted to the Web on: 12/1/2021
 
 



Basic Information

FACILITY CONTACT INFORMATION:
Address: 4102 SHORE DR
City: INDIANAPOLIS
Telephone: (317) 347-9051
Web Site:  
 
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
 
LICENSE INFORMATION:
  License number: 20-010666-1
  License effective date: 7/1/2020
  License expiration date: 6/30/2021
 


Administration and Staff

Administrator: 
  Start date: N/A
 
Director of Nursing: JENNIFER BLODGETT
  Start date: 4/20/2021
 
Medical director:  
  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
            JIM MILLER
            SARA JOYNER
            JOSH DAUGHERTY
            MARIA BOND
 
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: KINDRED NURSING CENTERS LIMITED PARTNERSHIP
Date of last change of ownership: 7/1/2013
 


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):        100
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     100
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            0
 
Total number of beds in facility:            100
 
CENSUS:
Facility census:  85
As reported by the facility on: 1/13/2020 
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 1/13/2020 
 
Residential care beds occupied:  0
As reported by the facility on: 1/13/2020 
 
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: FULLY SPRINKLERED
 
Number of comprehensive care resident rooms: 63
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: 63
 
  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 - TONY JAMES
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. MAINTENANCE DIRECTOR
Date form completed - 2/19/2020
 


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: 10/30/2022
 
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: 
     IVY TECH COMMUNITY COLLEGE
         Approved: 8/25/2003
         Terminated: 3/6/2006
     AREA 31 CAREER CENTER
         Approved: 11/30/1998
         Terminated: 3/6/2006
 


Complaints

NUMBER OF SUBSTANTIATED COMPLAINTS: 
 
  Current year:  5
  Previous year:  3
  2 years previous:  9

 


Enforcement Actions

 
Federal Certification Actions Imposed
     Civil Money Penalty
     Date Imposed: 4/21/2021  Date Ended: 5/25/2021
     Amount proposed per day: 1725
     Civil Money Penalty
     Date Imposed: 1/4/2021  Date Ended: 1/4/2021
     Amount proposed per day: 1000
     Directed Plan of Correction
     Date Imposed: 12/19/2020  Date Ended: 12/16/2020
     Directed Plan of Correction
     Date Imposed: 11/12/2020  Date Ended: 12/16/2020
     Directed Plan of Correction
     Date Imposed: 11/7/2020  Date Ended: 12/16/2020
     Directed Plan of Correction
     Date Imposed: 10/31/2020  Date Ended: 12/16/2020
     Discretionary Deny Pay for New Admits
     Date Imposed: 10/31/2020  Date Ended: 12/15/2020
     Civil Money Penalty
     Date Imposed: 9/25/2020  Date Ended: 12/15/2020
     Amount proposed per day: 9645
     Amount proposed per day: 330
     Amount proposed per day: 540
     Civil Money Penalty
     Date Imposed: 10/28/2019  Date Ended: 11/25/2019
     Amount proposed per day: 1140
     Mand. Deny Pay for New Admits-3 Mo.
     Date Imposed: 8/17/2019  Date Ended: 8/21/2019
     Civil Money Penalty
     Date Imposed: 6/1/2019  Date Ended: 8/21/2019
     Amount proposed per day: 6532
     Amount proposed per day: 515
     Directed Inservice Training
     Date Imposed: 4/24/2019  Date Ended: 4/24/2019
 
Date terminated from Medicare/Medicaid: 5/26/2021
 


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

44JJ11
Complaint
5/14/2021


GNP912
Complaint, Follow Up, Other
3/2/2021


8PMC11
Complaint, Other
2/12/2021


GNP911
Complaint, Other
1/14/2021


GBR912
Follow Up, Other
1/5/2021


YIRD12
Follow Up, Other
1/5/2021


Z1CB12
Complaint, Follow Up, Other
1/5/2021


6IMN12
Complaint, Follow Up, Other
1/5/2021


MWO011
Other
12/10/2020


Z1CB11
Complaint, Other
11/19/2020


6IMN11
Complaint, Other
10/19/2020


YIRD11
Other
10/14/2020


GBR911
Other
10/1/2020


O2PD12
Complaint, Follow Up
7/27/2020


R8R111
Complaint, Other
5/15/2020


O2PD11
Complaint
2/19/2020


9JNK11
Complaint
1/16/2020


T4C911
Complaint
1/6/2020


X5V411
Complaint
12/17/2019


B8H411
Complaint
12/4/2019


DQ6L12
Complaint, Follow Up
12/4/2019


DQ6L11
Complaint
10/29/2019


YUT011
Complaint
9/5/2019


JTWM12
Complaint, Follow Up
9/5/2019


WU0O12
Complaint, Follow Up
9/5/2019


C40512
Recertification, Follow Up, State Licensure
8/30/2019


C40522
Recertification, Follow Up, Life Safety Code
8/19/2019


WU0O11
Complaint
7/26/2019


JTWM11
Complaint
7/15/2019


C40521
Recertification, Life Safety Code
7/1/2019


C40511
Recertification, Complaint, State Licensure
5/17/2019


4EGB12
Complaint, Follow Up
4/23/2019


TNGD12
Complaint, Follow Up
4/23/2019


ZKNS11
Complaint
4/17/2019


QQ1Y12
Complaint, Follow Up
4/17/2019


TNGD11
Complaint
3/26/2019


4EGB11
Complaint
3/5/2019


QQ1Y11
Complaint
2/28/2019


E65411
Complaint
1/3/2019


DPAS11
Complaint
12/12/2018


 
 


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.