Indiana State Department of Health

INTERMEDIATE CARE FACILITY (ICF) CONSUMER REPORT

Created on: 03/07/2024 Posted to the Web on: 03/20/2024
INTERMEDIATE CARE FACILITY INFORMATION
Name and address of licensed ICF RES CARE SOUTHEAST INDIANA
16611 SIMA GRAY RD
HENRYVILLE, IN 47126
Telephone (812) 294-1155
Fax ( ) -
Name and address of licensee RES-CARE INC
9901 LINN STATION RD
LOUISVILLE, KY 40223
Telephone (502) 394-2100
Fax (502) 394-2285
Type of Ownership PRIVATE NON-PR
Name of administrator AMY KELLEY
Community based ICF No
Age range of clients served 27 to 50
Number of off-campus day program sites used by ICF clients 0
Number of discrete living units 1
Is the ICF a distinct part of a hospital, SNF or NF? No
Type of distinct part N/A
ICF Website
 
   
   
STATE LICENSURE SURVEYS
05/08/2023 Most Recent 12/02/2021 2nd Most Recent 10/26/2020 3rd Most Recent
Number of Deficiencies 4 6 8
State Average for the year of the survey (rounded to nearest whole integer.) 6 5 5
   
OWNERSHIP/ADMISTRATOR CHANGES
Type of Change 05/08/2023 Most Recent 12/02/2021 2nd Most Recent 10/26/2020 3rd Most Recent
Ownership Change No No No
Administrator Change No No No
   
   
SUBSTANTIATED COMPLAINTS
Any person may file a complaint with the ISDH about an ICF.  The ISDH 
investigates all complaints.  If in the course of the investigation a violation of 
state or federal rules or regulations is found by surveyors, the complaint is said 
'to be substantiated with findings.'  If the surveyor verifies the facts of the 
complaint but finds that no violation occurred of state rules or federal 
regulations, the complaint is said to be 'substantiated without findings.'  If 
deficiencies are cited on a complaint survey, the ICF may be requested by the
ISDH to complete a plan of correction on how and when they will correct each 
deficiency 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 
ICF and reviewed by the ISDH within fifteen (15) days of the survey.
   
The following is a summary of the number of substantiated complaint 
investigations for the past three years.  This only indicates whether the complaint 
was substantiated and does not indicate whether the ICF was found in 
compliance with state rules or federal regulations. 
Current Year 01/01/2023 to 12/31/2023 01/01/2022 to 12/31/2022
0 0 0
     
   
FEDERAL MEDICARE CERTIFICATION SURVEY RESULTS
Federal Medicare certification surveys are conducted to determine ICF 
compliance with the Federal Conditions of Participation.  For non-accredited 
federally certified ICF's, a federal Medicare certification survey is completed 
annually.  A federal certification survey may also be completed if 
the Center for Medicare and Medicaid Services (CMS) finds the ICF to be out 
of compliance with a federal condition of participation and CMS requests that a 
certification survey be completed.  The table below is a summary of the most 
recent federal certification survey.
Date of Last Federal Certification Survey 05/08/2023
Number of Standards not in compliance during the last federal certification survey 0
Number of Conditions not in compliance during the last federal certification survey 0
   
   
SURVEY HISTORY
 
The following is a list of state licensure, complaint, and federal 
surveys completed at the ICF in the past five years. 
 
The survey report is not posted until the report has been provided to the facility 
and their plan of correction submitted and approved, if required.
 
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
EVN221 Recertification, Life Safety Code 06/01/2023
EVN211 Recertification, State Licensure 05/08/2023
9GTV12 Complaint, Follow Up 08/05/2022
9GTV11 Complaint 06/21/2022
X8HX22 Recertification, Follow Up, Life Safety Code 03/07/2022
X8HX12 Recertification, Follow Up, State Licensure, Other 03/04/2022
X8HX21 Recertification, Life Safety Code 01/03/2022
X8HX11 Recertification, State Licensure, Other 12/02/2021
HHH211 Complaint 05/11/2021
FNUR12 Recertification, Follow Up, State Licensure 12/07/2020
FNUR21 Recertification, Life Safety Code 11/09/2020
FNUR11 Recertification, State Licensure 10/26/2020
0T4L11 Complaint, Other 08/17/2020
MFWT12 Complaint, Follow Up 08/17/2020
MFWT11 Complaint, Other 04/09/2020
SOFD21 Recertification, Life Safety Code 04/30/2019
SOFD11 Recertification, State Licensure 04/26/2019
 
 
LINKS AND RESOURCES
Choosing an ICF facility. Resources. Legal disclaimer for ICF reports.