| General |
| City |
| Indianapolis |
Peru |
| State attribute explanation |
| In |
In |
| Street |
| 5600 E 16th St |
390 W Boulevard |
| Zip Code |
| 46,218 |
46,970 |
| Phone |
| 3,173,560,911 |
7,654,734,900 |
|
Overall Star Rating |
| 5 |
4 |
|
Health Inspections Star Rating |
| 4 |
4 |
|
Nurse Staffing Star Rating |
| 3 |
2 |
|
Quality Measures Star Rating |
| 5 |
3 |
|
RN Only Star Rating |
| 3 |
3 |
|
Number of Certified Beds |
| 115 |
36 |
|
Total Number of Residents |
| 104 |
34 |
|
Percent of Occupied Beds |
| 90 % |
94 % |
| Health Survey Date |
| 6/7/2012 |
2/23/2012 |
| Fire Survey Date |
| 6/19/2012 |
3/9/2012 |
| Sprinkler Status |
| Fully Sprinklered |
Fully Sprinklered |
| Program Participation |
| Medicare And Medicaid |
Medicare And Medicaid |
| Type of Ownership |
| Government - County |
Non Profit - Corporation |
| Located Within a Hospital? |
| No |
No |
| Multi Nursing Home Ownership? |
| Yes |
Yes |
| Resident and Family Councils |
| Resident |
Resident |
| Continuing Care Retirement Community? |
| No |
No |
| Quality Indicator Survey? |
| Yes |
No |
| Special Focus Facility? |
| No |
No |
| Civil Money Penalty Count |
| 75.2 |
2 |
| Total Enforcement Actions Count |
| 75.2 |
2 |
| # of deficiencies |
| 7 |
3 |
|
| Staff Information |
| Number of Residents |
| 104 |
34 |
| Number of RN Hours Per Resident Per Day |
| 0.72 |
0.63 |
| Number of LPN/LVN Hours Per Resident Per Day |
| 1.42 |
0.63 |
| Total Number of Licensed Staff Hours Per Resident Per Day |
| 2.14 |
1.26 |
| Number of CNA Hours Per Resident Per Day |
| 0.11 |
0.03 |
| Number Therapy Hours Per Resident Per Day |
| 0.11 |
0.03 |
| Mistreatment Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: Develop Policies That Prevent Mistreatment, Neglect, Or Abuse Of Residents Or Theft Of Resident Property.survey Date: 07/23/2009date Of Correction: 08/13/2009 |
|
| Resident Rights Deficiencies |
| Deficiency #1 |
|
Scope: Fewlevel Of Harm: 2deficiency: Immediately Tell The Resident, The Resident's Doctor And A Family Member Of The Resident Of Situations (injury/decline/room, Etc.) That Affect The Resident.survey Date: 05/11/2010date Of Correction: 06/02/2010 |
| Quality Care Deficiencies |
| Deficiency #1 |
|
Scope: Fewlevel Of Harm: 3deficiency: Properly Care For Residents Needing Special Services, Including: Injections, Colostomy, Ureostomy, Ileostomy, Tracheostomy Care, Tracheal Suctioning, Respiratory Care, Foot Care, And Prostheses.survey Date: 05/11/2010date Of Correction: 06/02/2010 |
| Deficiency #2 |
|
Scope: Fewlevel Of Harm: 2deficiency: Provide Care By Qualified Persons According To Each Resident's Written Plan Of Care.survey Date: 05/11/2010date Of Correction: 06/02/2010 |
| Resident Assessment Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: Develop A Complete Care Plan That Meets All Of A Resident's Needs, With Timetables And Actions That Can Be Measured.survey Date: 08/12/2009date Of Correction: 08/26/2009 |
|
| Deficiency #2 |
| Scope: Fewlevel Of Harm: 2deficiency: Provide Doctors Orders For The Resident's Immediate Care, At The Time The Resident Was Admitted.survey Date: 08/12/2009date Of Correction: 08/26/2009 |
|
| Administration Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: 1) Ensure Lab Services, Blood Blanks And Transfusion Services Provided On Site Meet Requirements For Certified Laboratories; Or 2) Have An Agreement To Obtain Services From An Offsite Laboratory, That Meets The Same Requirements.survey Date: 08/04/2011date Of Correction: 08/26/2011 |
|
| Deficiency #2 |
| Scope: Fewlevel Of Harm: 2deficiency: Give Or Get Quality Lab Services/tests In A Timely Manner To Meet The Needs Of Residents.survey Date: 08/04/2011date Of Correction: 08/26/2011 |
|
| Deficiency #3 |
| Scope: Fewlevel Of Harm: 2deficiency: Keep Accurate, Complete And Organized Clinical Records On Each Resident That Meet Professional Standards.survey Date: 12/07/2010date Of Correction: 12/27/2010 |
|
| Pharmacy Service Deficiencies |
| Deficiency #1 |
| Scope: Fewlevel Of Harm: 2deficiency: At Least Once A Month, Have A Licensed Pharmacist Review Each Resident's Medication(s) And Report Any Irregularities To The Attending Doctor.survey Date: 12/07/2010date Of Correction: 12/27/2010 |
|
| Quality Measures Q1 |
| Percent of long-stay residents who received an antipsychotic medication |
| 33.3 % |
|
| Percent of long-stay residents whose need for help with daily activities has increased |
| 75.2 % |
|
| Percent of long-stay residents who self-report moderate to severe pain |
| 1.4 % |
|
| Percent of long-stay high-risk residents with pressure ulcers |
| 2.9 % |
|
| Percent of long-stay residents who lose too much weight |
| 2.1 % |
|
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 28.3 % |
|
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 2.5 % |
75.2 % |
| Percent of long-stay residents with a urinary tract infection |
| 4.2 % |
16.7 % |
| Percent of long-stay residents who have depressive symptoms |
| 1.1 % |
19.4:1 |
| Percent of long-stay residents who were physically restrained |
| 1.1 % |
75.2 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 1.8 % |
|
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 45.1 % |
|
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 43.1 % |
|
| Percent of short-stay residents who newly received an antipsychotic medication |
| 2.20 % |
75.2 |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 3.2 % |
9.7 % |
| Quality Measures Q3 |
| Percent of long-stay residents who received an antipsychotic medication |
| 28.3 % |
27.7 % |
| Percent of long-stay residents whose need for help with daily activities has increased |
| 0.4 % |
|
| Percent of long-stay residents who self-report moderate to severe pain |
| 5.2 % |
14.2 % |
| Percent of long-stay high-risk residents with pressure ulcers |
| 3.4 % |
12.5 % |
| Percent of long-stay residents who lose too much weight |
| 3.7 % |
7.5 % |
| Percent of long-stay low-risk residents who lose control of their bowels or bladder |
| 29 % |
65.6 % |
| Percent of long-stay residents who have had a catheter inserted and left in their bladder |
| 3.9 % |
1.1 % |
| Percent of long-stay residents with a urinary tract infection |
| 2.20 % |
14.6 % |
| Percent of long-stay residents who have depressive symptoms |
| 0.8 % |
14.3 % |
| Percent of long-stay residents who were physically restrained |
| 0.4 % |
75.2 % |
| Percent of long-stay residents experiencing one or more falls with major injury |
| 2.20 % |
14.6 % |
| Percent of short-stay residents who self-report moderate to severe pain |
| 12.5 % |
|
| Percent of short-stay residents assessed and given, appropriately, the seasonal influenza vaccine |
| 45.3 % |
|
| Percent of short-stay residents with Pressure ulcers that are new or worsened |
| 44.4 % |
|
| Percent of short-stay residents who newly received an antipsychotic medication |
| 20 % |
|