CLARK REHABILITATION AND SKILLED NURSING CENTER
CONSUMER REPORT Created on: 01/10/2013 Posted to the Web on: 01/23/2013 Facility ProfileReturn to Search Page
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Basic Information Address: 517 N LITTLE LEAGUE BLVD City: CLARKSVILLE Telephone: (812) 282-8406 View location on map Most recent name change: N/A Date of most recent name change: N/A Owning corporation: HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY 3838 N RURAL ST INDIANAPOLIS IN 46205 Ownership type: OTHER Officer(s): JAMES MINER LULA JOURNEY GREGORY FEHRIBACH ROBERT PFEIFER DAVID CRABB JOYCE IRWIN MATT GUTWEIN DAN SELLERS MAJORIE OLAUGHLIN Name of previous owner: N/A Date of last change of ownership: N/A Administrator: HOLLY NORTHAM Administrator start date: 09/22/2012 License number: 13-000059-1 License effective date: 01/01/2013 License expiration date: 12/31/2013 This facility is: FULLY SPRINKLERED Number of comprehensive care resident rooms: 45 Number of comprehensive care resident rooms with battery operated smoke detectors: 45 Number of comprehensive care resident rooms with hard wired and/or wireless smoke detectors: 0 Person completing form - NIKKI DADISMAN Title - ADMINISTRATOR Date form completed - 08/14/2012 Nurse Aide Training Competency Evaluation Program (NATCEP) NATCEP approved: 02/28/1997 NATCEP expires: 04/01/1999 NATCEP banned: YES NATCEP ban expires: 09/03/2011 This facility is a Clinical training site for the following NAT classroom sites: NURSES ON CALL NURSING AGENCY Approved: 03/23/2006 Terminated: 07/07/2006 NURSE TECH Approved: 05/09/2006 Terminated: 07/07/2006 LONG TERM CARE NURSING NETWORK Approved: N/A Terminated: 09/06/2003 CLARK REHABILITATION AND SKILLED NURSING CENTER Approved: N/A Terminated: 07/07/2006 Beds # of Medicaid beds (NF): 0 # of Medicare beds (SNF): 11 # of Medicare/Medicaid beds (SNF/NF): 72 Total number of comprehensive care beds: 83 # of non-certified comprehensive care beds: 0 Total number of residential beds: 0 Total number of beds in facility: 83 Facility census: 75 as of: 03/08/2012 Results of Surveys Date of last annual health survey: 02/24/2012 In substantial compliance on most recent annual health survey? NO If no, date facility achieved substantial compliance from annual health survey: 05/17/2012 Currently found in substantial compliance? Yes # of substantiated complaints: current year 0 # of substantiated complaints: previous year 10 # of substantiated complaints: 2 years previous 4 Substandard quality of care designations: Immediate jeopardy designations: N/A State Licensure Actions Event ID: 3RRX11 Action - Citation / Fine Notice to facility: 09/21/2004 Appeal: N/A Action Cease/Recind: 10/29/2004 Case Closed: 10/29/2004 Initial Amount: $2800 Event ID: Notice to facility: 11/24/1999 Appeal: N/A Action Cease/Recind: N/A Case Closed: N/A Initial Amount: $0 Event ID: Notice to facility: 10/29/1999 Appeal: 11/08/1999 Action Cease/Recind: N/A Case Closed: N/A Initial Amount: $0 Event ID: Action - Citation / Fine Notice to facility: 08/06/1998 Appeal: N/A Action Cease/Recind: 11/17/1998 Case Closed: 11/17/1998 Initial Amount: $3500 Federal Certification Actions Imposed Civil Money Penalty Date Imposed: 06/23/2010 Date Ended: 07/22/2010 Amount proposed per day: 150 Date terminated from Medicare.Medicaid: N/A CLARK REHABILITATION AND SKILLED NURSING CENTER
CONSUMER REPORT Created on: 01/10/2013 Posted to the Web on: 01/23/2013 Facility ProfileReturn to Search Page