HICKORY CREEK AT CONNERSVILLE
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: 2600 N GRAND AVE City: CONNERSVILLE Telephone: (765) 825-9771 View location on map Most recent name change: N/A Date of most recent name change: N/A Owning corporation: HICKORY CREEK HEALTHCARE FOUNDATION INC 6081 E 82ND ST STE 120 INDIANAPOLIS IN 46250 Ownership type: NON-PROFIT Officer(s): FRANCIS CROSBY JOHN STODDARD GARY WAYMIRE Name of previous owner: N/A Date of last change of ownership: N/A Administrator: LEA LOY Administrator start date: 10/22/2011 License number: 12-000319-1 License effective date: 11/01/2012 License expiration date: 10/31/2013 This facility is: FULLY SPRINKLERED Number of comprehensive care resident rooms: 18 Number of comprehensive care resident rooms with battery operated smoke detectors: 18 Number of comprehensive care resident rooms with hard wired and/or wireless smoke detectors: 0 Person completing form - LEA ANN LOY Title - ADMINISTRATOR Date form completed - 10/30/2012 Nurse Aide Training Competency Evaluation Program (NATCEP) NATCEP approved: 11/01/2012 NATCEP expires: 10/31/2013 NATCEP banned: NO NATCEP ban expires: N/A This facility is a Clinical training site for the following NAT classroom sites: HICKORY CREEK AT NEW CASTLE Approved: 01/27/2000 Terminated: N/A WHITEWATER TECHNICAL CAREER CENTER Approved: N/A Terminated: N/A NELLIS ADULT DAY CARE LLC Approved: 08/02/2011 Terminated: N/A GOLDEN LIVING CENTER-GOLDEN RULE Approved: 03/17/1995 Terminated: 03/20/1997 Beds # of Medicaid beds (NF): 0 # of Medicare beds (SNF): 0 # of Medicare/Medicaid beds (SNF/NF): 36 Total number of comprehensive care beds: 36 # of non-certified comprehensive care beds: 0 Total number of residential beds: 0 Total number of beds in facility: 36 Facility census: 30 as of: 12/07/2011 Results of Surveys Date of last annual health survey: 12/03/2011 In substantial compliance on most recent annual health survey? NO If no, date facility achieved substantial compliance from annual health survey: 12/23/2011 Currently found in substantial compliance? Yes # of substantiated complaints: current year 0 # of substantiated complaints: previous year 1 # of substantiated complaints: 2 years previous 0 Substandard quality of care designations: N/A Immediate jeopardy designations: N/A State Licensure Actions Event ID: P1DL11 Notice to facility: N/A Appeal: N/A Action Cease/Recind: N/A Case Closed: N/A Initial Amount: $0 Federal Certification Actions Imposed Date terminated from Medicare.Medicaid: N/A HICKORY CREEK AT CONNERSVILLE
CONSUMER REPORT Created on: 01/10/2013 Posted to the Web on: 01/23/2013 Facility ProfileReturn to Search Page