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MEADOWS MANOR NORTH

CONSUMER REPORT Created on: 01/10/2013 Posted to the Web on: 01/23/2013 Facility Profile
Basic Information Address: 3150 N SEVENTH ST City: TERRE HAUTE Telephone: (812) 466-5217 View location on map Most recent name change: N/A Date of most recent name change: N/A Owning corporation: MAJOR HOSPITAL 150 W WASHINGTON STREET SHELBYVILLE IN 46176 Ownership type: OTHER Name of previous owner: MEADOWS MANOR NORTH INC Date of last change of ownership: 01/01/2013 Administrator: WENDY MCNAMARA-BAKER Administrator start date: 07/30/2007 License number: 13-000067-1 License effective date: 01/01/2013 License expiration date: 12/31/2013 This facility is: FULLY SPRINKLERED Number of comprehensive care resident rooms: 52 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: 52 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 - PAUL BURN Title - BUILDING MANAGER Date form completed - 10/11/2012 Nurse Aide Training Competency Evaluation Program (NATCEP) NATCEP approved: 03/08/2004 NATCEP expires: 04/01/2006 NATCEP banned: YES NATCEP ban expires: 10/26/2011 This facility is a Clinical training site for the following NAT classroom sites: NURSE AIDE TRAINING SERVICES Approved: N/A Terminated: 08/18/2006 VIGO COUNTY SCHOOL CORP HEALTH Approved: N/A Terminated: 10/27/2009 MEADOWS MANOR NORTH Approved: N/A Terminated: 10/27/2009 Beds # of Medicaid beds (NF): 0 # of Medicare beds (SNF): 0 # of Medicare/Medicaid beds (SNF/NF): 104 Total number of comprehensive care beds: 104 # of non-certified comprehensive care beds: 0 Total number of residential beds: 0 Total number of beds in facility: 104 Facility census: 67 as of: 09/04/2012 Results of Surveys Date of last annual health survey: 09/04/2012 In substantial compliance on most recent annual health survey? NO If no, date facility achieved substantial compliance from annual health survey: 09/20/2012 Currently found in substantial compliance? Yes # of substantiated complaints: current year 0 # of substantiated complaints: previous year 0 # of substantiated complaints: 2 years previous 2 Substandard quality of care designations: 10/27/2009 08/18/2006 Immediate jeopardy designations: N/A 08/18/2006 State Licensure Actions Federal Certification Actions Imposed Civil Money Penalty Date Imposed: 07/15/2011 Date Ended: 07/15/2011 Amount proposed per day: 100 Amount proposed per day: Date terminated from Medicare.Medicaid: N/A

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