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Basic Information Address: 125 W MARGARET AVE City: TERRE HAUTE Telephone: (812) 232-3311 View location on map Most recent name change: N/A Date of most recent name change: N/A Owning corporation: BOARD OF TRUSTEES OF FLAVIUS J WITHAM MEMORIAL 12953 PUBLISHRS DR STE 200 FISHERS IN 46038 Ownership type: OTHER Officer(s): MARGARET MCFRYE DON BOYER MD JACK JONES NANCY MORTON BEVERLY NEWHART JUDY PSIKULA RAYMOND INGHAM GEORGE POGAS MELISSA GUM MICHELLE HINZE Name of previous owner: HOOSIER ENTERPRISES VIII INC Date of last change of ownership: 11/01/2011 Administrator: TRACY DEWEY Administrator start date: 12/14/2012 License number: 12-000139-1 License effective date: 11/01/2012 License expiration date: 10/31/2013 This facility is: FULLY SPRINKLERED Number of comprehensive care resident rooms: 57 Number of comprehensive care resident rooms with battery operated smoke detectors: 57 Number of comprehensive care resident rooms with hard wired and/or wireless smoke detectors: 0 Person completing form - SALLY ROBERTSON Title - ADMINISTRATOR Date form completed - 10/25/2012 Nurse Aide Training Competency Evaluation Program (NATCEP) NATCEP approved: 11/01/2012 NATCEP expires: 10/31/2013 NATCEP banned: YES NATCEP ban expires: 11/20/2009 This facility is a Clinical training site for the following NAT classroom sites: Beds # of Medicaid beds (NF): 0 # of Medicare beds (SNF): 0 # of Medicare/Medicaid beds (SNF/NF): 66 Total number of comprehensive care beds: 66 # of non-certified comprehensive care beds: 0 Total number of residential beds: 0 Total number of beds in facility: 66 Facility census: 48 as of: 09/21/2012 Results of Surveys Date of last annual health survey: 09/21/2012 In substantial compliance on most recent annual health survey? NO If no, date facility achieved substantial compliance from annual health survey: 10/14/2012 Currently found in substantial compliance? No # of substantiated complaints: current year 0 # of substantiated complaints: previous year 4 # of substantiated complaints: 2 years previous 0 Substandard quality of care designations: 08/05/2005 Immediate jeopardy designations: N/A 08/05/2005 State Licensure Actions Event ID: NZEY11 Action - Citation / Fine Notice to facility: 10/19/2004 Appeal: N/A Action Cease/Recind: 02/15/2005 Case Closed: 02/15/2005 Initial Amount: $2800 Federal Certification Actions Imposed Date terminated from Medicare.Medicaid: N/A WESTRIDGE HEALTH CARE CENTER
CONSUMER REPORT Created on: 01/10/2013 Posted to the Web on: 01/23/2013 Facility ProfileReturn to Search Page