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TODD DICKEY NURSING AND REHABILITATION CENTER

CONSUMER REPORT Created on: 01/10/2013 Posted to the Web on: 01/23/2013 Facility Profile
Basic Information Address: 712 W 2ND ST City: LEAVENWORTH Telephone: (812) 739-2292 View location on map Most recent name change: N/A Date of most recent name change: N/A Owning corporation: DEARBORN COUNTY HOSPITAL 600 WILSON CREEK RD DEARBORN IN 47025 Ownership type: OTHER Officer(s): PETER RESNICK PHILIP MEYER Name of previous owner: INDIANA HEALTH AND REHABILITATION CENTERS Date of last change of ownership: 09/01/2012 Administrator: STEPHANIE WISE Administrator start date: 06/07/2011 License number: 12-000490-1 License effective date: 09/01/2012 License expiration date: 08/31/2013 This facility is: FULLY SPRINKLERED Number of comprehensive care resident rooms: 32 Number of comprehensive care resident rooms with battery operated smoke detectors: 0 Number of comprehensive care resident rooms with hard wired and/or wireless smoke detectors: 0 Person completing form - STEPHANIE WISE Title - ADMINISTRATOR Date form completed - 07/26/2012 Nurse Aide Training Competency Evaluation Program (NATCEP) NATCEP approved: 03/05/2008 NATCEP expires: 04/01/2010 NATCEP banned: YES NATCEP ban expires: 10/16/2010 This facility is a Clinical training site for the following NAT classroom sites: INDIANA HEALTH CAREERS VOCATIONAL TRAINING & TEST Approved: 03/09/2007 Terminated: 10/17/2008 TODD DICKEY NURSING AND REHABILITATION CENTER Approved: 03/05/2008 Terminated: 06/30/2003 MEADOW VIEW HEALTH AND REHABILITATION CENTE Approved: 04/01/1999 Terminated: 06/30/2003 PROFESSIONAL CARE REHABILITATION CENTER Approved: 06/10/1999 Terminated: 06/30/2003 LOST RIVER CAREER COOPERATIVE Approved: N/A Terminated: 06/30/2003 PROSSER SCHOOL OF TECHNOLOGY Approved: 11/03/2010 Terminated: N/A MEDCO HEALTH AND REHABILITATION CENTER Approved: 11/12/1997 Terminated: 06/30/2003 Beds # of Medicaid beds (NF): 0 # of Medicare beds (SNF): 0 # of Medicare/Medicaid beds (SNF/NF): 78 Total number of comprehensive care beds: 78 # of non-certified comprehensive care beds: 0 Total number of residential beds: 0 Total number of beds in facility: 78 Facility census: 62 as of: 07/13/2012 Results of Surveys Date of last annual health survey: 07/13/2012 In substantial compliance on most recent annual health survey? NO If no, date facility achieved substantial compliance from annual health survey: 08/03/2012 Currently found in substantial compliance? Yes # of substantiated complaints: current year 0 # of substantiated complaints: previous year 0 # of substantiated complaints: 2 years previous 1 Substandard quality of care designations: 10/17/2008 Immediate jeopardy designations: N/A 10/17/2008 State Licensure Actions Event ID: EP3211 Action - Citation / Fine Notice to facility: 03/22/2005 Appeal: N/A Action Cease/Recind: 04/13/2005 Case Closed: 04/13/2005 Initial Amount: $3750 Event ID: VHWZ11 Action - Citation / Fine Notice to facility: 06/23/2003 Appeal: N/A Action Cease/Recind: 08/29/2003 Case Closed: 08/29/2003 Initial Amount: $5000 Event ID: 6WUE11 Action - Citation / Fine Notice to facility: 12/04/2001 Appeal: N/A Action Cease/Recind: 12/16/2001 Case Closed: 12/16/2001 Initial Amount: $4000 Event ID: Action - Citation / Fine Notice to facility: 03/11/1999 Appeal: N/A Action Cease/Recind: N/A Case Closed: N/A Initial Amount: $5250 Federal Certification Actions Imposed Civil Money Penalty Date Imposed: 07/13/2012 Date Ended: 08/02/2012 Amount proposed per day: 100 Date terminated from Medicare.Medicaid: N/A

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