Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
CUMBERLAND TRACE HEALTH & LIVING COMMUNITY
 
NURSING HOME
SKILLED NURSING FACILITY / NURSING FACILITY DISTINCT PART
Created on: 07/25/2025
 
Posted to the Web on: 08/06/2025
 
 



Basic Information

FACILITY CONTACT INFORMATION:
Address: 1925 REEVES ROAD
City: PLAINFIELD
Telephone: (317) 838-7070
Web Site:  
 
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
 
LICENSE INFORMATION:
  License number: 24-013455-1
  License effective date: 10/01/2024
  License expiration date: 09/30/2025
 


Administration and Staff

Administrator: WILLIAM BARNETT III
  Start date: 02/15/2020
 
Director of Nursing: ZACHARY WINKLE
  Start date: 07/29/2024
 
Medical director: ANTHONY ANDRES
  Start date:   /  /  
 
Wound care specialist:  
  Start date:   /  /  
 
Infection preventionist:  
  Start date:   /  /  
 


Ownership

CURENT OWNERSHIP:
 
Owning corporation: RIVERVIEW HOSPITAL
395 WESTFIELD ROAD
NOBLESVILLE IN 46060
 
Ownership type:  OTHER
 
Officer(s): WILLIAM KIRSCH
            GREG MURRAY
            LEEANN MURRAY
            CHARLES MULRY
            SAM MISHELOW
            MICHAEL DAUGHERTY
            JAYNA L FRIEND
            DAVE HYATT
            DAN STEVENS
            DOUG MYERS
            AMY CROUCH
            ERIC MARCOTTE
 
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: JAY COUNTY HOSPITAL
Date of last change of ownership: 10/01/2017
 


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):        70
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     104
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            126
 
Total number of beds in facility:            230
 
CENSUS:
Facility census:  160
As reported by the facility on: 07/17/2019
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 07/17/2019
 
Residential care beds occupied:  63
As reported by the facility on: 07/17/2019
 
Alzheimer Beds:  26
Alzheimer Beds Occupied:  11
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: 104
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: 104
 
  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 - SCOTT MUNROE
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. MAINTENANCE DIRECTOR
Date form completed - 04/03/2025
 


Nurse Aide Training

NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 09/27/2019
Nurse aide training and competency evaluation program (NATCEP) expires: 04/01/2025
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: 
     CUMBERLAND TRACE HEALTH & LIVING COMMUNITY
         Approved: 09/27/2019
         Terminated: 03/06/2021
     THE ATATJ INSTITUTE LLC
         Approved: 10/22/2021
         Terminated: N/A
     CARMEL HEALTH & LIVING COMMUNITY
         Approved: 06/02/2025
         Terminated: N/A
     UNIVERSITY HEIGHTS HEALTH AND LIVING COMMUNITY
         Approved: 08/31/2023
         Terminated: N/A
     AREA 31 CAREER CENTER
         Approved: 11/25/2024
         Terminated: N/A
     INDY INSTITUTE
         Approved: 04/04/2024
         Terminated: N/A
 


Complaints

NUMBER OF SUBSTANTIATED COMPLAINTS: 
 
  Current year:  0
  Previous year:  0
  2 years previous:  1

 


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
428
428
434
440


Rank of Score
15
13
12
10


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
No
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

 
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.


 
Event ID
Survey Type
Exit Date

RSKR12
Complaint, Follow Up, Recertification, State Licensure
06/25/2025


RSKR21
Life Safety Code, Recertification
06/18/2025


RSKR11
Recertification, Complaint, State Licensure
05/23/2025


6OTU11
Complaint
01/03/2025


DH2X22
Follow Up, Life Safety Code, Recertification
07/11/2024


DH2X12
Follow Up, Recertification, State Licensure
06/14/2024


DH2X21
Recertification, Life Safety Code
05/21/2024


DH2X11
Recertification, Complaint, State Licensure
04/23/2024


3JT711
Complaint
01/17/2024


M67I11
Complaint
08/29/2023


I6YE22
Recertification, Follow Up, Life Safety Code
05/04/2023


I6YE12
Recertification, Complaint, Follow Up, State Licensure
03/20/2023


I6YE21
Recertification, Life Safety Code
03/07/2023


I6YE11
Recertification, Complaint, State Licensure
02/16/2023


X13X11
Complaint
10/31/2022


2CNZ11
Complaint
08/26/2022


 
 


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.