Created on: 07/25/2025
Posted to the Web on: 08/06/2025
Basic Information
FACILITY CONTACT INFORMATION:
Address: 1335 S GUILFORD ROAD
City: CARMEL
Telephone: (317) 810-1800
Web Site:
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
LICENSE INFORMATION:
License number: 24-013212-1
License effective date: 08/01/2024
License expiration date: 07/31/2025
Administration and Staff
Administrator: KARA OWEN
Start date: 09/30/2024
Director of Nursing: MELISSA FORRESTER
Start date: 12/07/2024
Medical director: Marwan Mustaklem
Start date: / /
Wound care specialist: Todd Mann
Start date: / /
Infection preventionist:
Start date: / /
Ownership
CURENT OWNERSHIP:
Owning corporation: PRAIRIE LANDING COMMUNITY, INC
5415 BEARBERRY LANE
INDIANAPOLIS IN 46268
Ownership type: NON-PROFIT
Officer(s): LOWELL DEAN JONES
ROGER MILLER
JOHN DATTILO
ROGER WEIDEMAN II
WILLIAM HURT
JANE SEIGEL
WENDY MEREDITH
HARRY KENNERK
JOHN LIPSON
JANE RICHARDSON
JEFFREY A TERP
DEXTER COOLEY
JEFFREY CALDWELL
SHAWNA GOTTLIEB
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: MAYFLOWER COMMUNITIES INC.
Date of last change of ownership: 08/30/2019
Bed Counts and Census
COMPREHENSIVE CARE BEDS:
Number of Medicaid beds (NF): 0
Number of Medicare beds (SNF): 8
Number of Medicare/Medicaid beds (SNF/NF): 0
Number of non-certified comprehensive care beds (State Licensed only): 40
Total number of comprehensive care beds: 8
RESIDENTIAL CARE BEDS:
Total number of residential beds: 106
Total number of beds in facility: 154
CENSUS:
Facility census: 107
As reported by the facility on: 01/16/2024
Number of comprehensive care beds occupied in this facility. 19
As reported by the facility on: 01/16/2024
Residential care beds occupied: 75
As reported by the facility on: 01/16/2024
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: 48
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: 48
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 - RYAN RAMIREZ
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. ENVIRON SERVICES DIR
Date form completed - 04/15/2025
Nurse Aide Training
NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 11/25/2020
Nurse aide training and competency evaluation program (NATCEP) expires: 04/01/2026
Nurse aide training and competency evaluation program (NATCEP) banned: Yes
Nurse aide training and competency evaluation program (NATCEP) ban expires: 12/01/2017
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites:
LEGACY MEDICAL ACADEMY
Approved: 10/25/2019
Terminated: N/A
BARRINGTON OF CARMEL, THE
Approved: 11/25/2020
Terminated: N/A
TOWNE HOUSE RETIREMENT COMMUNITY
Approved: 06/07/2022
Terminated: N/A
WESLEY MANOR HEALTH CENTER
Approved: 11/17/2022
Terminated: N/A
WESTMINSTER VILLAGE NORTH
Approved: 06/30/2025
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
405
375
390
387
Rank of Score
26
40
35
36
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
No
No
Owner Change
No
No
No
Number of Substantiated Complaints With Deficiencies
0
0
0
Deficiency Free Standard Health Survey
Yes
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: OXVQ11
Action - Citation / Fine
Notice to facility: N/A
Appeal: N/A
Action Cease/Recind: 12/17/2024
Case Closed: 12/17/2024
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.
