WILLOW CROSSING HEALTH & REHABILITATION CENTER
CONSUMER REPORT Created on: 01/10/2013 Posted to the Web on: 01/23/2013 Facility ProfileReturn to Search Page
Back to Health Care Regulatory Services
Basic Information Address: 3550 CENTRAL AVE City: COLUMBUS Telephone: (812) 379-9669 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 V INC Date of last change of ownership: 11/01/2011 Administrator: DAWN WENDEL Administrator start date: 09/04/2007 License number: 12-000572-1 License effective date: 11/01/2012 License expiration date: 10/31/2013 This facility is: FULLY SPRINKLERED Number of comprehensive care resident rooms: 45 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: 45 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 - TIM STRICKER Title - MAINTENANCE Date form completed - 07/24/2012 Nurse Aide Training Competency Evaluation Program (NATCEP) NATCEP approved: 09/13/2005 NATCEP expires: 04/01/2009 NATCEP banned: YES NATCEP ban expires: 11/06/2010 This facility is a Clinical training site for the following NAT classroom sites: COLUMBUS AREA CAREER CONNECTION Approved: 12/13/2012 Terminated: N/A WILLOW CROSSING HEALTH & REHABILITATION CENTER Approved: 09/13/2005 Terminated: 11/07/2008 IVY TECH COMMUNITY COLLEGE Approved: 09/28/2005 Terminated: 11/07/2008 MCDOWELL ADULT EDUCATION CENTER Approved: 12/21/2005 Terminated: 11/07/2008 OAKBROOK VILLAGE Approved: 08/27/2001 Terminated: 11/07/2008 ATTERBURY JOB CORPS Approved: N/A Terminated: 11/07/2008 Beds # of Medicaid beds (NF): 0 # of Medicare beds (SNF): 13 # of Medicare/Medicaid beds (SNF/NF): 67 Total number of comprehensive care beds: 80 # of non-certified comprehensive care beds: 0 Total number of residential beds: 0 Total number of beds in facility: 80 Facility census: 63 as of: 10/31/2011 Results of Surveys Date of last annual health survey: 10/21/2011 In substantial compliance on most recent annual health survey? NO If no, date facility achieved substantial compliance from annual health survey: 11/07/2011 Currently found in substantial compliance? Yes # of substantiated complaints: current year 0 # of substantiated complaints: previous year 2 # of substantiated complaints: 2 years previous 2 Substandard quality of care designations: N/A Immediate jeopardy designations: N/A State Licensure Actions Event ID: Action - Emergency order ban on admissions Notice to facility: 03/01/1999 Appeal: N/A Action Cease/Recind: N/A Case Closed: N/A Initial Amount: $0 Event ID: Notice to facility: 03/03/1999 Appeal: 03/16/1999 Action Cease/Recind: N/A Case Closed: N/A Initial Amount: $0 Federal Certification Actions Imposed Date terminated from Medicare.Medicaid: N/A WILLOW CROSSING HEALTH & REHABILITATION CENTER
CONSUMER REPORT Created on: 01/10/2013 Posted to the Web on: 01/23/2013 Facility ProfileReturn to Search Page