AVALON VILLAGE
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: 200 KINGSTON CIR City: LIGONIER Telephone: (260) 894-7131 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: HOOSIER ENTERPRISES VII INC Date of last change of ownership: 01/01/2012 Administrator: JESSICA SLONE Administrator start date: 04/01/2009 License number: 13-000184-1 License effective date: 01/01/2013 License expiration date: 12/31/2013 This facility is: FULLY SPRINKLERED Number of comprehensive care resident rooms: 34 Number of comprehensive care resident rooms with battery operated smoke detectors: 34 Number of comprehensive care resident rooms with hard wired and/or wireless smoke detectors: 0 Person completing form - JESSICA SLONE Title - EXECUTIVE DIRECTOR Date form completed - 09/05/2012 Nurse Aide Training Competency Evaluation Program (NATCEP) NATCEP approved: 03/16/2005 NATCEP expires: 04/01/2013 NATCEP banned: NO NATCEP ban expires: N/A This facility is a Clinical training site for the following NAT classroom sites: IVY TECH COMMUNITY COLLEGE Approved: 06/11/2002 Terminated: N/A MANNIA GREEN HEALTHCARE ADVANTAGE, INC Approved: 08/16/2002 Terminated: 03/12/2003 IVY TECH COMMUNITY COLLEGE Approved: 03/23/2006 Terminated: N/A AVALON VILLAGE Approved: N/A Terminated: N/A Approved: 05/23/1997 Terminated: N/A HAGEN HEALTH EDUCATION Approved: 07/27/2011 Terminated: N/A Beds # of Medicaid beds (NF): 0 # of Medicare beds (SNF): 0 # of Medicare/Medicaid beds (SNF/NF): 67 Total number of comprehensive care beds: 67 # of non-certified comprehensive care beds: 0 Total number of residential beds: 0 Total number of beds in facility: 67 Facility census: 47 as of: 08/10/2012 Results of Surveys Date of last annual health survey: 08/10/2012 In substantial compliance on most recent annual health survey? NO If no, date facility achieved substantial compliance from annual health survey: 08/24/2012 Currently found in substantial compliance? Yes # of substantiated complaints: current year 0 # of substantiated complaints: previous year 3 # of substantiated complaints: 2 years previous 1 Substandard quality of care designations: N/A Immediate jeopardy designations: N/A State Licensure Actions Event ID: 1LBI11 Action - Citation / Fine Notice to facility: 01/09/2004 Appeal: N/A Action Cease/Recind: 12/19/2004 Case Closed: 12/19/2004 Initial Amount: $4750 Federal Certification Actions Imposed Date terminated from Medicare.Medicaid: N/A AVALON VILLAGE
CONSUMER REPORT Created on: 01/10/2013 Posted to the Web on: 01/23/2013 Facility ProfileReturn to Search Page