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RANDOLPH NURSING HOME
CONSUMER REPORT
Created on: 01/10/2013
Posted to the Web on: 01/23/2013
 
Facility Profile
 

Basic Information
Address: 701 S OAK ST
City: WINCHESTER
Telephone: (765) 584-2201
 
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Most recent name change: N/A
Date of most recent name change: N/A
Owning corporation: HOOSIER CARE II INC
535 W SECOND  STE 105
LEXINGTON KY 40508
Ownership type:  NON-PROFIT
Officer(s): BRUCE HUTSON
            STEPHEN WOOD
            JANET GILLESPIE
            JOHN GILLMOR
 
Name of previous owner: N/A
Date of last change of ownership: N/A
Administrator: ALLEN GOODMAN
Administrator start date: 12/03/2012
License number: 12-000136-1
License effective date: 06/01/2012
License expiration date: 05/31/2013
 
This facility is: FULLY SPRINKLERED
Number of comprehensive care resident rooms: 49
Number of comprehensive care resident rooms with battery
                    operated smoke detectors: 49
Number of comprehensive care resident rooms
             with hard wired and/or wireless smoke detectors: 0
Person completing form - JONI HOWELL
  Title - HFA
Date form completed - 08/08/2012
 
Nurse Aide Training Competency Evaluation Program (NATCEP)
NATCEP approved: 03/03/2005
NATCEP expires:  04/01/2011
NATCEP banned: YES
NATCEP ban expires: 06/06/2013
This facility is a Clinical training site for the following NAT classroom sites: 
     IVY TECH COMMUNITY COLLEGE
         Approved: 11/13/2000
       Terminated: 07/30/2010
     RANDOLPH NURSING HOME
         Approved: 01/17/2001
       Terminated: 07/30/2010
 
Beds
# of Medicaid beds (NF):                     0
# of Medicare beds (SNF):                    0
# of Medicare/Medicaid beds (SNF/NF):        94
Total number of comprehensive care beds:     94
# of non-certified comprehensive care beds:  0
Total number of residential beds:            0
Total number of beds in facility:            94
Facility census:  73 as of: 06/18/2012
 
Results of Surveys
Date of last annual health survey: 06/15/2012
In substantial compliance on most recent annual health survey? NO
If no, date facility achieved substantial compliance
from annual health survey: N/A
Currently found in substantial compliance? Yes
 
# of substantiated complaints: current year  0
# of substantiated complaints: previous year  1
# of substantiated complaints: 2 years previous  1
Substandard quality of care designations: N/A
 
Immediate jeopardy designations: N/A
 
 
State Licensure Actions
Event ID: 
  Action - Citation / Fine
 Notice to facility: 06/23/1999
             Appeal: N/A
Action Cease/Recind: N/A
         Case Closed: N/A
Initial Amount: $3000
 
Federal Certification Actions Imposed
     Civil Money Penalty
     Date Imposed: 04/06/2011  Date Ended: 04/21/2011
     Amount proposed per day: 600
     Mand. Deny Pay for New Admits-3 Mo.
     Date Imposed: 07/30/2010  Date Ended: 08/02/2010
     Civil Money Penalty
     Date Imposed: 06/10/2010  Date Ended: 08/02/2010
     Amount proposed per day: 300
 
Date terminated from Medicare.Medicaid: N/A
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