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

Basic Information
Address: 762 N DAN JONES RD
City: AVON
Telephone: (317) 495-7200
 
View location on map
 
Most recent name change: N/A
Date of most recent name change: N/A
Owning corporation: HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY
3838 N RURAL ST
INDIANAPOLIS IN 46205
Ownership type:  OTHER
Officer(s): JAMES MINER
            LULA JOURNEY
            GREGORY FEHRIBACH
            ROBERT PFEIFER
            DAVID CRABB
            JOYCE IRWIN
            MATT GUTWEIN
            DAN SELLERS
            MAJORIE OLAUGHLIN
 
Name of previous owner: COUNTRYSIDE MEADOWS LLC
Date of last change of ownership: 08/01/2012
Administrator: COLLEEN MATTHEWS
Administrator start date: 08/11/2012
License number: 12-012534-1
License effective date: 08/01/2012
License expiration date: 07/31/2013
 
This facility is: FULLY SPRINKLERED
Number of comprehensive care resident rooms: 89
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: 89
  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 - MAX JONES
  Title - ED
Date form completed - 08/09/2012
 
Nurse Aide Training Competency Evaluation Program (NATCEP)
NATCEP approved: 08/01/2012
NATCEP expires:  07/31/2013
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):                    40
# of Medicare/Medicaid beds (SNF/NF):        131
Total number of comprehensive care beds:     171
# of non-certified comprehensive care beds:  0
Total number of residential beds:            0
Total number of beds in facility:            171
Facility census:  133 as of: 08/10/2012
 
Results of Surveys
Date of last annual health survey: 08/10/2012
In substantial compliance on most recent annual health survey? NO
If no, date facility achieved substantial compliance
from annual health survey: 09/09/2012
Currently found in substantial compliance? Yes
 
# of substantiated complaints: current year  0
# of substantiated complaints: previous year  2
# of substantiated complaints: 2 years previous  1
Substandard quality of care designations: N/A
 
Immediate jeopardy designations: N/A
 
 
State Licensure Actions
 
Federal Certification Actions Imposed
 
Date terminated from Medicare.Medicaid: N/A
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