Inspection Reports for Evergreen Village at Bloomington
IN, 3607 S Heirloom Dr, Bloomington, IN 47401, United States
Back to Facility ProfileInspection Report Summary
The most recent inspection on May 1, 2025, found no deficiencies related to the complaint investigated at that time. Earlier inspections showed a mixed record, with most complaint investigations resulting in no deficiencies, but two substantiated complaints related to medication security and narcotic discrepancies were cited in late 2022 and late 2023. Deficiencies primarily involved medication management issues, specifically the protection and accurate accounting of controlled substances, as well as some minor issues with resident rights postings noted in mid-2024. No fines, immediate jeopardy findings, or license actions were listed in the available reports. The facility appears to have addressed some prior medication security concerns, as more recent complaint investigations have not identified related deficiencies.
Deficiencies (last 4 years)
Deficiencies (over 4 years)
1 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
76% better than Indiana average
Indiana average: 4.2 deficiencies/yearDeficiencies per year
4
3
2
1
0
Census
Latest occupancy rate
113 residents
Based on a May 2025 inspection.
Census over time
Inspection Report
Complaint Investigation
Census: 113
Deficiencies: 0
Date: May 1, 2025
Visit Reason
This visit was for a State Residential Licensure Survey and included the Investigation of Complaint IN00458525.
Complaint Details
Complaint IN00458525 was investigated and found to have no deficiencies related to the allegations.
Findings
No deficiencies related to the complaint allegations were cited. The facility was found to be in compliance with 410 IAC 16.2-5 regarding the State Residential Licensure Survey and the complaint investigation.
Report Facts
Residential Census: 113
Inspection Report
Renewal
Census: 119
Deficiencies: 2
Date: Jul 25, 2024
Visit Reason
This visit was for a State Residential Licensure Survey conducted on July 24 and 25, 2024, to assess compliance with state regulations for Evergreen Village at Bloomington.
Findings
The facility was found noncompliant with requirements related to posting of resident rights information and accessibility of the facility survey book. Specifically, signage with important contact information was posted too high to be easily viewed by residents, and the survey book was not readily accessible or clearly located for residents.
Deficiencies (2)
Failure to ensure known addresses and telephone numbers of relevant agencies were posted in an area easily accessible to residents.
Failure to ensure the results of the most recent annual survey, plan of correction, and subsequent surveys were in an identified location accessible to residents.
Report Facts
Residential Census: 119
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Nichole McNally | Executive Director | Signed the report as the facility representative |
Inspection Report
Complaint Investigation
Census: 113
Deficiencies: 0
Date: May 21, 2024
Visit Reason
This visit was conducted for the investigation of Complaint IN00433797.
Complaint Details
Complaint IN00433797 was investigated and found to have no deficiencies related to the allegations.
Findings
No deficiencies related to the allegations were cited. The facility was found to be in compliance with 410 IAC 16.2-5 regarding the complaint investigation.
Report Facts
Residential Census: 113
Inspection Report
Complaint Investigation
Census: 114
Deficiencies: 1
Date: Dec 7, 2023
Visit Reason
The visit was conducted for the investigation of Complaint IN00418647 regarding allegations of medication loss and theft.
Complaint Details
Complaint IN00418647 was substantiated with state deficiencies cited at R64 related to medication loss and theft.
Findings
The facility failed to exercise reasonable care for the protection of residents' medication from loss and theft for 2 of 2 residents reviewed. Controlled substance logs were incomplete and narcotic medications were missing.
Deficiencies (1)
Failed to exercise reasonable care for the protection of residents' medication from loss and theft for 2 of 2 residents reviewed. Controlled substance logs were not completed and narcotic medications were missing.
Report Facts
Residential Census: 114
Controlled Substance Log audit frequency: 3
Controlled Substance Log audit frequency: 2
Controlled Substance Log audit frequency: 1
Compliance date: Dec 27, 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Josh Dodds | Executive Director | Signed the report |
| Director of Nursing | Interviewed regarding missing medications for Resident B and Resident C | |
| LPN 1 | Licensed Practical Nurse | Observed signing Controlled Substance Log during medication room observation |
Inspection Report
Complaint Investigation
Census: 107
Deficiencies: 0
Date: Sep 20, 2023
Visit Reason
This visit was conducted for the investigation of Complaint IN00415735.
Complaint Details
Complaint IN00415735 was investigated and found to have no deficiencies related to the allegations.
Findings
No deficiencies related to the allegations were cited. The facility was found to be in compliance with 410 IAC 16.2-5 regarding the complaint investigation.
Inspection Report
Renewal
Census: 115
Deficiencies: 0
Date: Aug 16, 2023
Visit Reason
This visit was for a State Residential Licensure Survey conducted on August 15 and 16, 2023.
Findings
Evergreen Village At Bloomington was found to be in compliance with 410 IAC 16.2-5 in regard to the State Residential Licensure Survey.
Inspection Report
Complaint Investigation
Census: 113
Deficiencies: 0
Date: Jun 22, 2023
Visit Reason
This visit was for the Investigation of Complaint IN00410963.
Complaint Details
Complaint IN00410963 was investigated and found to have no deficiencies related to the allegations.
Findings
No deficiencies related to the allegations were cited. The facility was found to be in compliance with 410 IAC 16.2-5 regarding the complaint investigation.
Inspection Report
Complaint Investigation
Census: 115
Deficiencies: 0
Date: May 10, 2023
Visit Reason
This visit was for the Investigation of Complaint IN00407573.
Complaint Details
Investigation of Complaint IN00407573 found no deficiencies related to the allegations.
Findings
No deficiencies related to the allegations were cited. The facility was found to be in compliance with 410 IAC 16.2-5 regarding the complaint.
Inspection Report
Census: 115
Deficiencies: 0
Date: Nov 11, 2022
Visit Reason
This visit was for a Quality Assurance Walk Through Survey.
Findings
Evergreen Village At Bloomington was found to be in compliance with 410 IAC 16.2-5 in regard to the Quality Assurance Walk Through Survey.
Inspection Report
Census: 114
Deficiencies: 0
Date: Nov 10, 2022
Visit Reason
This visit was for a State Residential Licensure Survey conducted on November 9 and 10, 2022.
Findings
Evergreen Village At Bloomington was found to be in compliance with 410 IAC 16.2-5 in regard to the State Residential Licensure Survey.
Inspection Report
Complaint Investigation
Census: 116
Deficiencies: 1
Date: Sep 28, 2022
Visit Reason
This visit was for the investigation of Complaint IN00385338, which was substantiated with state deficiencies related to the allegations cited at R64.
Complaint Details
Complaint IN00385338 was substantiated. The facility failed to properly secure medications for Resident C, leading to a narcotic medication discrepancy and subsequent termination of QMA 1.
Findings
The facility failed to properly secure medications for one of three residents reviewed (Resident C), resulting in a medication discrepancy where a narcotic medication was unaccounted for and replaced with a non-narcotic pill. The QMA responsible was terminated, and systemic corrective actions including audits and narcotic counts were implemented.
Deficiencies (1)
Facility failed to properly secure medications for Resident C, resulting in a narcotic medication discrepancy.
Report Facts
Residential Census: 116
Employees mentioned
| Name | Title | Context |
|---|---|---|
| QMA 1 | Qualified Medication Aide | Terminated based on findings related to medication discrepancy |
| QMA 2 | Qualified Nursing Assistant | Reported the torn medication care pack for Resident C |
| DON | Director of Nursing | Provided facility policy and oversaw corrective actions and audits |
Viewing
Loading inspection reports...
