Created on: 9/20/2024
Posted to the Web on: 10/2/2024
Basic Information
FACILITY CONTACT INFORMATION:
Address: 3320 EAST STATE BOULEVARD
City: FORT WAYNE
Telephone: (260) 235-5957
Web Site:
NAME CHANGES:
Most recent name change: CEDAR RIDGE OF FORT WAYNE
Date of most recent name change: 7/19/2023 11:01:07 AM
LICENSE INFORMATION:
License number: 23-012107-2
License effective date: 7/11/2023
License expiration date: 6/30/2024
CURENT OWNERSHIP:
Owning corporation: FORT WAYNE NURSING AND REHABILITATION LLC
N/A
N/A N/A N/A
Ownership type: PROFIT
Officer(s): DAVID BRICKMAN
GLORIA HOLLAND
DAVID BEATHARD
ROBERT HOLLISTER
CAREY HENDRICKSON
CORPORATION CAPITAL SNR LIVING
PROPERTIES 4 CAPITAL SNR LVG
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: FORT WAYNE NURSING AND REHABILITATION LLC
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): 0
Number of non-certified comprehensive care beds (State Licensed only): 0
Total number of comprehensive care beds: 0
RESIDENTIAL CARE BEDS:
Total number of residential beds: 153
Total number of beds in facility: 153
CENSUS:
Facility census: 68
As reported by the facility on: 1/1/2020 2
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 1/1/2020 2
Residential care beds occupied: 68
As reported by the facility on: 1/1/2020 2
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: / /
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: 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:
Complaints
NUMBER OF SUBSTANTIATED COMPLAINTS:
Current year: 0
Previous year: 1
2 years previous: 1
State Licensure Surveys
The ISDH conducts a state licensure survey at each licensed residential facility
approximately once per year. If state findings are cited on a survey, the
residential facility may be requested by the ISDH to complete a plan of
correction on how and when they will correct each state finding and who will be
responsible to ensure the corrections are made and will not reoccur in the future.
The plan of correction is generally submitted by the residential facility and
reviewed by the ISDH within fifteen (15) days of the survey.
To read an overview of the survey process, click hereNOTE:
The residential consumer report survey information begins with surveys that
have been completed on or after December 1, 2008. Any survey performed prior
to that date will not have any information in the state findings count rows or
columns or will show zero.
7/12/2023 Most Recent
10/28/2022 2nd Most Recent
3/4/2020 3rd Most Recent
Number of state findings
0
2
8
State Average for the year of the survey (rounded to nearest whole integer).
