Indiana State Department of Health

Division of Long Term Care

CONSUMER REPORT

APERION CARE ARBORS MICHIGAN CITY

NURSING HOME

SKILLED NURSING FACILITY / NURSING FACILITY DISTINCT PART

Created on: 07/05/2019

Posted to the Web on: 07/17/2019
Basic Information
FACILITY CONTACT INFORMATION: Address: 1101 E COOLSPRING AVE City: MICHIGAN CITY Telephone: (219) 874-5211 Web Site: NAME CHANGES: Most recent name change: N/A Date of most recent name change: N/A LICENSE INFORMATION: License number: 19-000076-1 License effective date: 03/01/2019 License expiration date: 02/28/2020
Administration and Staff
Administrator: LORRI LYNN MAPLES Start date: 02/28/2019 Director of Nursing: PATRICIA BULTEMA Start date: 06/07/2019 Medical director: Start date: / / Wound care specialist: Start date: / / Infection preventionist: Start date: / /
Ownership
CURENT OWNERSHIP: Owning corporation: MAJOR HOSPITAL 2451 INTELLPLEX DR SHELBYVILLE IN 46176 Ownership type: OTHER Officer(s): DANA CALDWELL DOUGLAS CARTER MD JEFF BEATY JOHN COFFIN JAN SANDMAN SHERRI TANDY JOHN HORNER GENE JONES SCOTT MILLER RALPH MERCURI LINDA WESSIC ILYA SHUMAN PREVIOUS OWNERSHIP CHANGES: Name of previous owner: THE ARBORS OPERATOR, LLC Date of last change of ownership: 03/01/2013
Bed Counts and Census
COMPREHENSIVE CARE BEDS: Number of Medicaid beds (NF): 0 Number of Medicare beds (SNF): 33 Number of Medicare/Medicaid beds (SNF/NF): 147 Number of non-certified comprehensive care beds (State Licensed only): 0 Total number of comprehensive care beds: 180 RESIDENTIAL CARE BEDS: Total number of residential beds: 0 Total number of beds in facility: 180 CENSUS: Facility census: 129 As reported by the facility on: 01/03/2019 Number of comprehensive care beds occupied in this facility. 0 As reported by the facility on: 01/03/2019 Residential care beds occupied: 0 As reported by the facility on: 01/03/2019 Alzheimer Beds: 38 Alzheimer Beds Occupied: 22 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: 127 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: 127 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 - LORRI MOPLES Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. EXECUTIVE DIRECTOR Date form completed - 03/13/2019
Nurse Aide Training
NURSE AIDE TRAINING PROGRAM APPROVALS: Nurse aide training and competency evaluation program (NATCEP) approved: 03/22/2000 Nurse aide training and competency evaluation program (NATCEP) expires: 04/01/2002 Nurse aide training and competency evaluation program (NATCEP) banned: Yes Nurse aide training and competency evaluation program (NATCEP) ban expires: 03/12/2021 CLINICAL TRAINING SITES: This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: MED ED INCORPORATED Approved: 06/17/2009 Terminated: 03/05/2015 A K SMITH CAREER CENTER Approved: 05/11/2009 Terminated: 03/05/2015 IN TRAINING COLLEGE OF ADULT EDUCATION Approved: 04/09/1997 Terminated: 01/29/2002 MICHIGAN CITY HIGH SCHOOL HEALTH OCCUPATIONS Approved: 05/28/1997 Terminated: 01/29/2002 PROFESSIONAL RESOURCES Approved: 04/26/1996 Terminated: 01/29/2002 APERION CARE ARBORS MICHIGAN CITY Approved: 03/18/1996 Terminated: 05/09/2007
Complaints
NUMBER OF SUBSTANTIATED COMPLAINTS: 
 
  Current year:  6
  Previous year:  5
  2 years previous:  7
Facility Report Card
 
   We are experiencing technical issues with the consumer report card system.
   We are working to resolve the issue.
 
The statewide average line is being provided to give you a reference
for looking at the scores of the selected facility.  This row 
contains the mean average calculated scores for all facilities as of
above date resulting in a scoring range of 0 to 621.
Scores are considered to be better the closer to zero they are.
Percentile rank of 100 represents the lowest report card score or best performing facility,
with a rank of 1 being the highest report card score.
 
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 Yes
Substandard Quality of Care No No Yes
Administrator Change Yes 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 Mand. Deny Pay for New Admits-3 Mo. Date Imposed: 03/13/2019 Date Ended: 03/21/2019 Directed Inservice Training Date Imposed: 01/30/2019 Date Ended: 01/30/2019 Directed Plan of Correction Date Imposed: 04/30/2018 Date Ended: 04/17/2018 Civil Money Penalty Date Imposed: 01/30/2018 Date Ended: 01/30/2018 Amount proposed per day: 505 Amount proposed per day: Civil Money Penalty Date Imposed: 06/12/2017 Date Ended: 07/23/2017 Amount proposed per day: 710 Amount proposed per day: 9049 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
KV9P21 Recertification, Life Safety Code 06/11/2019
KV9P11 Recertification, Complaint, State Licensure 05/20/2019
L4CK12 Complaint, Follow Up 05/08/2019
L4CK11 Complaint 04/02/2019
MVRH22 Complaint, Follow Up, Life Safety Code 03/28/2019
3EW211 Complaint 03/07/2019
WIH712 Complaint, Follow Up 03/05/2019
MVRH21 Complaint, Life Safety Code 02/22/2019
K0UT22 Follow Up, Life Safety Code, Recertification 02/22/2019
WIH711 Complaint 02/05/2019
K0UT13 Recertification, Follow Up, State Licensure 01/31/2019
K0UT12 Recertification, Follow Up, State Licensure 01/04/2019
K0UT21 Recertification, Life Safety Code 12/13/2018
K0UT11 Recertification, State Licensure 11/20/2018
HZQU12 Complaint, Follow Up 10/26/2018
HZQU11 Complaint 10/11/2018
YFEJ11 Complaint 09/11/2018
PLLU12 Complaint, Follow Up 07/30/2018
OJNI11 Complaint 07/30/2018
JR6N11 Complaint 07/16/2018
PLLU11 Complaint 06/27/2018
1X7B21 Complaint, Life Safety Code 06/25/2018
0TYP11 Complaint 06/19/2018
MSMD11 Complaint 05/23/2018
HPYD22 Follow Up, Life Safety Code, Other 05/15/2018
RO5U12 Complaint, Follow Up 05/01/2018
RO5U11 Complaint 04/18/2018
XSCK23 Recertification, Follow Up, Life Safety Code 04/17/2018
HPYD21 Life Safety Code, Other 04/03/2018
XSCK22 Recertification, Follow Up, Life Safety Code 04/03/2018
9TEC12 Complaint, Follow Up 03/16/2018
XSCK21 Recertification, Life Safety Code 02/01/2018
9TEC11 Complaint 01/30/2018
XSCK12 Recertification, Follow Up, State Licensure 01/24/2018
XSCK11 Recertification, State Licensure 12/18/2017
OXGY11 Complaint 11/27/2017
ZWGG11 Complaint 11/01/2017
IT2J11 Complaint 10/05/2017
YW7I11 Complaint 09/11/2017
ZBXX12 Complaint, Follow Up 08/08/2017
03V412 Complaint, Follow Up 08/08/2017
ZBXX11 Complaint 06/29/2017
03V411 Complaint 06/13/2017
FT7D12 Complaint, Follow Up 06/13/2017
VEUM11 Complaint 05/19/2017
FT7D11 Complaint 05/11/2017
4J6Z12 Complaint, Follow Up 03/10/2017
7J7B11 Complaint 02/22/2017
4J6Z11 Complaint 02/07/2017
O5B022 Recertification, Follow Up, Life Safety Code 01/25/2017
O6SK11 Complaint 12/29/2016
BP1K12 Complaint, Follow Up 12/29/2016
1NWQ12 Complaint, Follow Up 12/29/2016
O5B012 Complaint, Follow Up, Recertification, State Licensure 12/29/2016
O5B021 Recertification, Life Safety Code 12/13/2016
BP1K11 Complaint 11/27/2016
1NWQ11 Complaint 10/29/2016
O5B011 Complaint, Recertification, State Licensure 10/28/2016
RRX112 Complaint, Follow Up 10/20/2016
RRX111 Complaint 09/23/2016
OQNU11 Complaint 08/15/2016
 
 
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.