Indiana State Department of Health

Division of Long Term Care

CONSUMER REPORT

WATERS OF SCOTTSBURG, THE

NURSING HOME

SKILLED NURSING FACILITY / NURSING FACILITY DUALLY CERTIFIED

Created on: 07/05/2019

Posted to the Web on: 07/17/2019
Basic Information
FACILITY CONTACT INFORMATION: Address: 1350 N TODD DR City: SCOTTSBURG Telephone: (812) 752-5663 Web Site: NAME CHANGES: Most recent name change: N/A Date of most recent name change: N/A LICENSE INFORMATION: License number: 18-000478-1 License effective date: 09/01/2018 License expiration date: 08/31/2019
Administration and Staff
Administrator: CAROL ROSEMEYER Start date: 07/11/2016 Director of Nursing: DEBRA GOBEN Start date: 09/06/2016 Medical director: Start date: / / Wound care specialist: Start date: / / Infection preventionist: Start date: / /
Ownership
CURENT OWNERSHIP: Owning corporation: DEARBORN COUNTY HOSPITAL 600 WILSON CREEK RD DEARBORN IN 47025 Ownership type: OTHER Officer(s): ALBERT KEN INGRAM ROBERT SCHROEDER RONALD DENNEY CARL PETTY BETTY BISCHOFF WILLIAM RITZMANN ROBERT MOORHEAD MICHAEL SCHWEBLER MATTHEW JONES SANDRA JONES HENRY STEINMETZ YISROEL BORNSTEIN NISSON HIRSCH PREVIOUS OWNERSHIP CHANGES: Name of previous owner: THE WATERS OF SCOTTSBURG II LLC Date of last change of ownership: 09/01/2012
Bed Counts and Census
COMPREHENSIVE CARE BEDS: Number of Medicaid beds (NF): 0 Number of Medicare beds (SNF): 0 Number of Medicare/Medicaid beds (SNF/NF): 99 Number of non-certified comprehensive care beds (State Licensed only): 0 Total number of comprehensive care beds: 99 RESIDENTIAL CARE BEDS: Total number of residential beds: 0 Total number of beds in facility: 99 CENSUS: Facility census: 69 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: 26 Alzheimer Beds Occupied: 19 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: 55 Number of comprehensive care resident rooms with battery operated smoke detectors: 55 Number of comprehensive care resident rooms with hard wired and/or wireless smoke detectors: 0 Person completing form - SHAWN COLWELL Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. MAINTENANCE SUPERVIS Date form completed - 03/29/2017
Nurse Aide Training
NURSE AIDE TRAINING PROGRAM APPROVALS: Nurse aide training and competency evaluation program (NATCEP) approved: 02/16/2000 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: 08/07/2019 CLINICAL TRAINING SITES: This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: WATERS OF SCOTTSBURG, THE Approved: 03/07/2000 Terminated: 07/16/2013 INDIANA HEALTH CAREERS VOCATIONAL TRAINING & TEST Approved: 08/11/2015 Terminated: 07/11/2016
Complaints
NUMBER OF SUBSTANTIATED COMPLAINTS: 
 
  Current year:  1
  Previous year:  0
  2 years previous:  0
Facility Report Card
 
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   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 Yes Yes
Substandard Quality of Care No No Yes
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 Civil Money Penalty Date Imposed: 04/30/2019 Date Ended: 04/30/2019 Amount proposed per day: Civil Money Penalty Date Imposed: 03/29/2017 Date Ended: 03/29/2017 Amount proposed per day: 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
X9C312 Complaint, Follow Up 06/24/2019
X9C311 Complaint 04/30/2019
DWMD11 Complaint 12/20/2018
FML912 Recertification, Follow Up, State Licensure 12/14/2018
FML922 Follow Up, Life Safety Code, Recertification 12/03/2018
FML921 Recertification, Life Safety Code 10/25/2018
FML911 Recertification, Complaint, State Licensure 10/24/2018
BTDF11 Complaint 10/24/2018
2J9012 Complaint, Follow Up 08/27/2018
2J9011 Complaint 07/26/2018
MF2R21 Recertification, Life Safety Code 01/29/2018
MF2R12 Recertification, Follow Up, State Licensure 01/23/2018
MF2R11 Recertification, State Licensure 12/15/2017
8R2J11 Complaint 11/13/2017
K93E11 Complaint 07/20/2017
YNQ222 Follow Up, Life Safety Code, Recertification 05/25/2017
ECV011 Complaint 04/24/2017
YNQ212 Recertification, Follow Up, State Licensure 03/29/2017
YNQ221 Recertification, Life Safety Code 03/29/2017
YNQ211 Recertification, Complaint, State Licensure 02/24/2017
U76311 Complaint 08/29/2016
RNN012 Complaint, Follow Up 08/29/2016
5XDC12 Complaint, Follow Up 07/11/2016
RNN011 Complaint 07/11/2016
 
 
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.