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SHIELDS HOUSE
CONSUMER REPORT
Created on: 01/10/2013
Posted to the Web on: 01/23/2013
 
Facility Profile
 

Basic Information
Address: 2288 NICHOLAS CT
City: SEYMOUR
Telephone: (812) 523-8991
 
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Most recent name change: N/A
Date of most recent name change: N/A
Owning corporation: ASSISTED LIVING CONCEPTS INC.
W140 N 8981 LILLY ROAD
MENOMONEE FALLS WI 53051
Ownership type:  PROFIT
Officer(s): WALTER LEVONOWICH
            JOHN BUONO
            MARY ZAK-KOWALCZYK
            CHARLES ROADMAN
 
Name of previous owner: N/A
Date of last change of ownership: N/A
Administrator: LUAN DESKINS
Administrator start date: 07/09/2012
License number: 12-004376-1
License effective date: 11/01/2012
License expiration date: 10/31/2013
 
 
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: 
 
Beds
# of Medicaid beds (NF):                     0
# of Medicare beds (SNF):                    0
# of Medicare/Medicaid beds (SNF/NF):        0
Total number of comprehensive care beds:     0
# of non-certified comprehensive care beds:  0
Total number of residential beds:            47
Total number of beds in facility:            47
Facility census: N/A as of: N/A
 
# of substantiated complaints: current year  0
# of substantiated complaints: previous year  0
# of substantiated complaints: 2 years previous  2
 
State Licensure Actions
Event ID: 307D11
  Action - Citation / Fine
 Notice to facility: N/A
             Appeal: N/A
Action Cease/Recind: 12/20/2011
         Case Closed: 12/20/2011
Initial Amount: $3000
Event ID: 6JW011
  Action - Citation / Fine
 Notice to facility: 06/24/2011
             Appeal: N/A
Action Cease/Recind: N/A
         Case Closed: 10/20/2011
Initial Amount: $2500
 
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