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WESTMINSTER VILLAGE - WEST LAFAYETTE
CONSUMER REPORT
Created on: 01/10/2013
Posted to the Web on: 01/23/2013
 
Facility Profile
 

Basic Information
Address: 2741 N SALISBURY ST
City: WEST LAFAYETTE
Telephone: (765) 463-7546
 
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Most recent name change: N/A
Date of most recent name change: N/A
Owning corporation: WESTMINSTER VILLAGE WEST LAFAYETTE INC
2741 N SALISBURY ST
WEST LAFAYETTE IN 47906
Ownership type:  NON-PROFIT
Officer(s): JAMES RANSOM
            RONALD FRUITT
            D MAXINE WILSON
            ROBERT WEEDER
 
Name of previous owner: N/A
Date of last change of ownership: N/A
Administrator: JUDITH BANE
Administrator start date: 05/21/2001
License number: 12-000093-1
License effective date: 03/01/2012
License expiration date: 02/28/2013
 
This facility is: FULLY SPRINKLERED
Number of comprehensive care resident rooms: 72
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: 72
  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 - JUDITH BANE
  Title - ADMINISTRATOR
Date form completed - 10/18/2012
 
Nurse Aide Training Competency Evaluation Program (NATCEP)
NATCEP approved: 03/23/2006
NATCEP expires:  04/01/2014
NATCEP banned: NO
NATCEP ban expires: N/A
This facility is a Clinical training site for the following NAT classroom sites: 
     CUMBERLAND POINTE HEALTH CAMPUS
         Approved: 07/22/1996
       Terminated: 04/11/2000
     TIPPECANOE SCHOOL CORPORATION
         Approved: N/A
       Terminated: N/A
     WILDCAT CREEK CAREER COOPERATIVE
         Approved: 08/10/2012
       Terminated: N/A
     WESTMINSTER VILLAGE - WEST LAFAYETTE
         Approved: N/A
       Terminated: N/A
 
Beds
# of Medicaid beds (NF):                     0
# of Medicare beds (SNF):                    72
# of Medicare/Medicaid beds (SNF/NF):        0
Total number of comprehensive care beds:     72
# of non-certified comprehensive care beds:  0
Total number of residential beds:            76
Total number of beds in facility:            148
Facility census:  49 as of: 11/30/2011
 
Results of Surveys
Date of last annual health survey: 11/02/2011
In substantial compliance on most recent annual health survey? NO
If no, date facility achieved substantial compliance
from annual health survey: 11/28/2011
Currently found in substantial compliance? Yes
 
# of substantiated complaints: current year  0
# of substantiated complaints: previous year  0
# of substantiated complaints: 2 years previous  0
Substandard quality of care designations: N/A
 
Immediate jeopardy designations: N/A
 
 
State Licensure Actions
Event ID: XB2I11
  Action - Citation / Fine
 Notice to facility: 03/02/2005
             Appeal: N/A
Action Cease/Recind: 08/27/2005
         Case Closed: 08/27/2005
Initial Amount: $2250
 
Federal Certification Actions Imposed
 
Date terminated from Medicare.Medicaid: N/A
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