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Residential Care Facility Licensing Program
Program Overview
The Residential Care Facility Licensing Program conducts health surveys and investigates complaints in order to assess the compliance of about 100 residential care providers with the rules and regulations.
Contact the Program
Indiana State Department of Health
Division of Long Term Care
2 North Meridian Street, 4B
Indianapolis, IN 46204
(317) 233-7442 (Long Term Care Receptionist)
(317) 233-1325 (ISDH Main Switchboard)
Map
Program Manager
Miriam Buffington
mbuffington@isdh.in.gov
(317) 233-7613
(317) 233-7322 [Fax]
Questions: Ltcproviderservices@isdh.IN.gov
Report a Complaint or Incident to the ISDH
Report a complaint regarding a health care facility
Individuals can call or email to make complaints about care provided at any licensed or certified Indiana health care providers or suppliers.
Report an incident regarding a health care facility
The Incident Report Form is for health care facilities to notify the Indiana State Department of Health of a reportable incident pursuant to the ISDH Reportable Unusual Occurrence Policy. The Incident Report Form is also for health care facility staff (nursing homes, intermediate care facilities, and hospice agencies) to report a reasonable suspicion of a crime against a resident pursuant to Federal regulations. This form is not to be used to file a complaint.
Consumer Information
Advance Directives Resource Center
Out of Hospital Do Not Resuscitate Declaration and Order
Consumer Reports
Residential Care Facility Consumer Reports
Directories
Directory of Free Standing Residential Care Facilities
Directory of Non-Free Standing Residential Care Facilities
Employment Opportunities
Learn more about Employment Opportunities with the Indiana State Department of Health
Facility Changes
Administrator or Director of Nursing Change Form
Application for Conversion from Residential Care to Non-Certified Comprehensive Care Facility
Application for Conversion from State Licensed Only to Medicare/Medicaid Participation
Bed Change and Remodeling Requests
Change of Ownership Residential Facility
Forms
Administrator or Director of Nursing Change Form
Application for Approval of the Dining Assistant Program
Application for Construction Permit for Long Term Care Facilities
Application for License to Operate a Health Facility
Application for Renewal of Health Facility License
Employee Records
Notice of Transfer and Discharge
Notice of Transfer and Discharge Request for Hearing
Nurse Aide Registry CNA Renewal
QMA Record of Annual In-service Training
Laws and Regulations
State Laws and Rules
Indiana Code 16-28-2; Licensure of Health Facilities
410 IAC 7-24; Retail Food Establishment Sanitation Requirements
410 IAC 16.2; Licensure of Health Facilities Rules
410 IAC 16.2-5: Residential Regulations
412 IAC 1; Emergency Relocation of Residents
412 IAC 2; Qualified Medication Aides
Indiana Law and Rules Homepage
Limited Criminal History Search
Links
Ombudsman and Resident Protection Agencies
Office of the Long Term Care Ombudsman
402 West Washington Street, Room W451
Post Office Box 7083, MS 27
Indianapolis, Indiana 46207-7083
Information/complaint line: 800-622-4484 or 317-232-7134
Fax number: 317-972-3285
Email: LongTermCareOmbudsman@ombudsman.IN.gov
https://www.in.gov/ombudsman/2347.htm
Professional Organizations
American Health Information Management Association
Association of Professionals in Infection Control and Epidemiology
Hoosier Owners and Providers for the Elderly
Indiana Assisted Living Association
Indiana Chapter of the American Physical Therapy Association
Indiana Health Care Association
Indiana State Medical Association
Indiana State Nurses Association
State Government
Division of Mental Health and Addiction (FSSA)
Indiana Public Access Counselor
Office of Medicaid Policy and Planning (FSSA)
Federal Government
Agency for Healthcare Research and Quality (AHRQ)
Americans with Disabilities Act (ADA)
Centers for Disease Control and Prevention (CDC)
Centers for Medicare and Medicaid Services (CMS)
National Patient Safety Foundation
Newsletters
Newsletters and Subscription Home Page
Program Information and Policies
Construction Plan Review for Long Term Care Facilities
ISDH Program Guidance Letter LTC-2005-01
Alzheimer and Dementia training requirements for comprehensive and residential facilities.