Inspection Report
Complaint Investigation
Census: 55
Deficiencies: 0
Jun 4, 2025
Visit Reason
This visit was conducted for the investigation of Complaint IN00459526 at Bloom At Eagle Creek.
Findings
No deficiencies related to the allegations in Complaint IN00459526 were cited. The facility was found to be in compliance with 410 IAC 16.2-5 regarding the complaint investigation.
Complaint Details
Complaint IN00459526 was investigated and found to have no deficiencies related to the allegations.
Report Facts
Residential Census: 55
Inspection Report
Renewal
Census: 53
Deficiencies: 8
Aug 29, 2024
Visit Reason
This visit was for a State Residential Licensure Survey conducted on August 28 and 29, 2024, to assess compliance with state residential regulations.
Findings
The facility was found deficient in multiple areas including failure to report resident-to-resident verbal abuse, inadequate employee training on Resident Rights and Abuse/Neglect, failure to ensure pets were vaccinated, medication administration and storage issues, sanitation and safety concerns in the kitchen, and lack of an effective infection control program.
Deficiencies (8)
| Description |
|---|
| Failed to ensure verbal abuse was reported to the Administrator for 1 of 1 observation of resident-to-resident verbal abuse. |
| Failed to ensure new hire and ongoing in-service training included minimum requirements for Resident's Rights, Abuse/Neglect, and Dementia training for 6 of 6 employee records reviewed. |
| Failed to ensure pets were vaccinated for the safety of all residents for 2 of 2 pets reviewed. |
| Failed to monitor a resident's blood pressure prior to administering blood pressure medication as ordered for 1 of 5 residents reviewed. |
| Failed to ensure dietary staff had hair covered, clean air conditioning vents, and appropriate dates on food in the kitchen. |
| Failed to ensure all medications were secure for a resident who self-administered medications. |
| Failed to store medications safely, date medications, and label medication bottles, insulins, inhalers, and eye drops for multiple residents. |
| Failed to implement an infection control program to analyze patterns of known infection symptoms for the facility. |
Report Facts
Residents affected: 53
Employee records reviewed: 6
Pets reviewed: 2
Residents medications reviewed: 5
Medication carts observed: 3
Insulin basket observed: 1
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Michael Scott McCoskey | Executive Director | Named as Executive Director responsible for oversight and plan of correction |
| Community Relations 9 | Staff member present during verbal abuse incident | |
| Certified Nurse Aide 10 | CNA | Staff member present during verbal abuse incident |
| Certified Nurse Aide 11 | CNA | Staff member present during verbal abuse incident |
| Housekeeper 12 | Housekeeper | Employee record reviewed for training compliance |
| Qualified Medication Aide 13 | QMA | Employee record reviewed for training compliance |
| Qualified Medication Aide 14 | QMA | Employee record reviewed for training compliance |
| Activity Director | Activity Director | Employee record reviewed for training compliance |
| Licensed Practical Nurse 16 | LPN | Employee record reviewed for training compliance |
| Qualified Medication Aide 17 | QMA | Employee record reviewed for training compliance |
| Wellness Director | Named as responsible for medication administration oversight and infection control program | |
| Dietary Manager | Named in relation to kitchen sanitation deficiencies | |
| Cook 6 | Cook | Named in relation to kitchen sanitation deficiencies |
| Licensed Practical Nurse | LPN | Interviewed regarding medication labeling and dating |
Inspection Report
Follow-Up
Census: 52
Deficiencies: 0
Jul 17, 2023
Visit Reason
This visit was for the Post Survey Revisit (PSR) to the Investigation of Complaint IN00409427 completed on June 08, 2023.
Findings
Bloom At Eagle Creek was found to be in compliance with 410 IAC 16.2-5 in regard to the PSR to the Investigation of Complaint IN00409427.
Complaint Details
Complaint IN00409427 - Corrected.
Inspection Report
Complaint Investigation
Census: 48
Deficiencies: 1
Jun 7, 2023
Visit Reason
This visit was conducted for the investigation of Complaint IN00409427 regarding allegations related to resident safety and elopement.
Findings
The facility failed to ensure proper management and oversight of a resident with exit-seeking behaviors, resulting in the elopement of a confused resident who wandered approximately 2 miles away from the facility. The resident was missing for several hours before being found and returned. The facility lacked documentation of preventive elopement interventions and delayed notifying police.
Complaint Details
Complaint IN00409427 was substantiated with state deficiencies cited related to the allegations. The resident eloped on 5/15/23, was missing for several hours, and was found approximately 2 miles away. The facility delayed notifying police and lacked documentation of elopement prevention plans.
Deficiencies (1)
| Description |
|---|
| Failed to ensure management and oversight of a resident with exit seeking behaviors, resulting in elopement. |
Report Facts
Resident census: 48
Distance wandered: 2
Time missing: 4.75
Vital signs: 97.9
Vital signs: 81
Vital signs: 18
Vital signs: 187102
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Helga Bradley | Executive Director | Facility representative signing the report |
| QMA 11 | Qualified Medication Aide | Documented resident missing and participated in search |
| QMA 9 | Qualified Medication Aide | Provided interview about resident's exit seeking behaviors |
| LPN 10 | Licensed Practical Nurse | Provided interview about elopement binder and resident behaviors |
| Wellness Director | Provided multiple interviews regarding resident care, elopement risk, and search efforts | |
| Area Director of Operations | Provided interview about search efforts and elopement policy | |
| Administrator | Involved in search and communication during elopement incident | |
| Maintenance Supervisor | Reported seeing resident outside and brought her back inside | |
| Detective | Indianapolis Metropolitan Police Department detective interviewed about incident | |
| Community Relations Director | Provided interview about resident admission and behaviors |
Inspection Report
Renewal
Deficiencies: 8
Apr 26, 2023
Visit Reason
This visit was for a State Residential Licensure Survey conducted on April 25 and 26, 2023.
Findings
The facility was found deficient in multiple areas including failure to provide meals to a hospice resident, improper food storage and handling, medication labeling and storage issues, failure to document medication disposal, incomplete clinical records regarding advanced directives, lack of infection control program and hand hygiene deficiencies during medication administration.
Deficiencies (8)
| Description |
|---|
| Failed to provide a meal to a resident receiving hospice services. |
| Raw meats stored over prepared foods and food not sealed or dated; failure to wear beard guard during food service. |
| Failed to label an open bottle of Tubersol medication. |
| Medication/treatment cart was unlocked and unsecured. |
| Failed to dispose of a resident's medications in compliance with laws. |
| Failed to document code status/advanced directives on physician order sheets for multiple residents. |
| Failed to establish an infection control program that includes surveillance and monitoring of infections. |
| Failed to ensure staff washed hands during medication administration for 3 of 5 residents observed. |
Report Facts
Residents served from kitchen: 55
Residents reviewed for advanced directives: 5
Residents observed for medication administration: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Helga Bradley | Executive Director | Signed the report and involved in interviews regarding deficiencies. |
| Wellness Director | Provided information on diet orders, medication storage, infection control, and corrective actions. | |
| Dietary Manager | Involved in food storage and handling deficiencies. | |
| LPN 6 | Observed failing to provide meal and hand hygiene during medication administration. | |
| Dietary Aide 9 | Observed not wearing beard guard during food service. | |
| Wellness Coordinator | Provided information on medication labeling and disposal. |
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