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PINE HAVEN HEALTH AND REHABILITATION CENTER
CONSUMER REPORT
Created on: 01/10/2013
Posted to the Web on: 01/23/2013
 
Facility Profile
 

Basic Information
Address: 3400 STOCKER DR
City: EVANSVILLE
Telephone: (812) 424-8100
 
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Most recent name change: N/A
Date of most recent name change: N/A
Owning corporation: CBH II INC
3400 STOCKER DR
EVANSVILLE IN 47720
Ownership type:  PROFIT
Officer(s): CHARLES BOWMAN
 
Name of previous owner: N/A
Date of last change of ownership: N/A
Administrator: LAURA BARNETT
Administrator start date: 02/06/2012
License number: 12-000442-1
License effective date: 02/01/2012
License expiration date: 01/31/2013
 
This facility is: FULLY SPRINKLERED
Number of comprehensive care resident rooms: 71
Number of comprehensive care resident rooms with battery
                    operated smoke detectors: 37
Number of comprehensive care resident rooms
             with hard wired and/or wireless smoke detectors: 34
  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 - MARK PFINGSTON
  Title - MAINTENANCE DIRECTOR
Date form completed - 09/11/2012
 
Nurse Aide Training Competency Evaluation Program (NATCEP)
NATCEP approved: 03/13/2001
NATCEP expires:  04/01/2003
NATCEP banned: YES
NATCEP ban expires: 05/04/2013
This facility is a Clinical training site for the following NAT classroom sites: 
     IVY TECH COMMUNITY COLLEGE
         Approved: 03/26/2002
       Terminated: 06/25/2009
     SIGNATURE HIGH SCHOOL LEARNING CENTER
         Approved: 10/14/1998
       Terminated: 06/25/2009
     PINE HAVEN HEALTH AND REHABILITATION CENTER
         Approved: 05/20/1997
       Terminated: 06/25/2009
     VISITING NURSE PLUS
         Approved: N/A
       Terminated: 06/25/2009
 
Beds
# of Medicaid beds (NF):                     0
# of Medicare beds (SNF):                    51
# of Medicare/Medicaid beds (SNF/NF):        69
Total number of comprehensive care beds:     120
# of non-certified comprehensive care beds:  0
Total number of residential beds:            0
Total number of beds in facility:            120
Facility census:  97 as of: 01/09/2012
 
Results of Surveys
Date of last annual health survey: 12/19/2011
In substantial compliance on most recent annual health survey? NO
If no, date facility achieved substantial compliance
from annual health survey: 01/13/2012
Currently found in substantial compliance? Yes
 
# of substantiated complaints: current year  0
# of substantiated complaints: previous year  1
# of substantiated complaints: 2 years previous  6
Substandard quality of care designations: 
     04/14/2011
     06/25/2009
 
Immediate jeopardy designations: N/A
     04/14/2011
     06/25/2009
 
 
State Licensure Actions
 
Federal Certification Actions Imposed
     Civil Money Penalty
     Date Imposed: 05/02/2011  Date Ended: 07/06/2011
     Amount proposed per day: 200
     Amount proposed per day: 3700
 
Date terminated from Medicare.Medicaid: N/A
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