Inspection Report
Complaint Investigation
Census: 48
Deficiencies: 0
Mar 25, 2025
Visit Reason
This visit was conducted for the investigation of Complaint IN00455210.
Findings
No deficiencies related to the complaint allegations were cited. The facility was found to be in compliance with applicable regulations.
Complaint Details
Complaint IN00455210 was investigated and found to have no deficiencies related to the allegations.
Report Facts
Census Bed Type Total: 48
Census Payor Type Total: 30
SNF/NF Beds: 29
SNF Beds: 1
Residential Beds: 18
Medicare Residents: 2
Medicaid Residents: 11
Other Payor Residents: 17
Inspection Report
Complaint Investigation
Census: 50
Deficiencies: 0
Feb 10, 2025
Visit Reason
This visit was conducted for the investigation of Complaint IN00452339.
Findings
No deficiencies related to the complaint allegations were cited. The facility was found to be in compliance with applicable regulations.
Complaint Details
Complaint IN00452339 was investigated and found to have no deficiencies related to the allegations.
Report Facts
Census Bed Type Total: 50
Census Payor Type Total: 37
Census Bed Type SNF/NF: 36
Census Bed Type SNF: 1
Census Bed Type Residential: 13
Census Payor Type Medicare: 8
Census Payor Type Medicaid: 10
Census Payor Type Other: 19
Inspection Report
Complaint Investigation
Census: 55
Deficiencies: 0
Aug 28, 2024
Visit Reason
This visit was conducted for the investigation of Complaint IN00438198.
Findings
No deficiencies related to the complaint allegations were cited. The facility was found to be in compliance with applicable regulations.
Complaint Details
Complaint IN00438198 was investigated and found to have no deficiencies related to the allegations.
Report Facts
Census Bed Type Total: 55
Census Payor Type Total: 36
SNF/NF Beds: 35
SNF Beds: 1
Residential Beds: 19
Medicare Residents: 1
Medicaid Residents: 14
Other Payor Residents: 21
Inspection Report
Follow-Up
Census: 39
Capacity: 42
Deficiencies: 0
Aug 28, 2024
Visit Reason
A Post Survey Revisit (PSR) was conducted for the Emergency Preparedness Survey and the Life Safety Code Recertification and State Licensure Survey that exited on 07/02/24.
Findings
At this Emergency Preparedness PSR, Parkview Haven was found in compliance with Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers. At the Life Safety Code PSR, the facility was found in compliance with Requirements for Participation in Medicare/Medicaid and Life Safety from Fire standards.
Report Facts
Certified beds: 42
Census: 39
Generator capacity: 350
Inspection Report
Annual Inspection
Deficiencies: 0
Jul 2, 2024
Visit Reason
The inspection was conducted as a paper compliance review for the Annual Recertification and State Licensure, including the State Residential Licensure Survey completed on June 3, 2024.
Findings
Parkview Haven was found to be in compliance with 42 CFR Part 483, Subpart B and 410 IAC 16.2-3.1 based on the paper review for the Recertification and State Licensure survey and the State Residential Licensure Survey.
Inspection Report
Life Safety
Census: 39
Capacity: 42
Deficiencies: 4
Jul 2, 2024
Visit Reason
An Emergency Preparedness Survey and a Life Safety Code Recertification and State Licensure Survey were conducted by the Indiana Department of Health in accordance with 42 CFR 483.73 and 42 CFR 483.90(a) respectively on 07/02/2024.
Findings
The facility was found not in compliance with Emergency Preparedness Requirements and Life Safety Code requirements including failure to maintain required emergency generator testing and documentation, and an exit door lock requiring a complex code. Deficiencies could affect all residents and staff.
Severity Breakdown
SS=F: 3
SS=E: 1
Deficiencies (4)
| Description | Severity |
|---|---|
| The emergency generator lacked monthly load testing and a 4-hour 36-month exercise required by Life Safety Code and NFPA 110. | SS=F |
| The means of egress through 1 of 5 exit doors was not readily accessible due to a lock requiring a complex code deciphering, affecting approximately 15 residents and staff. | SS=E |
| Failed to maintain a complete written record of monthly generator load testing for 1 of the last 12 months. | SS=F |
| Failed to maintain documentation of a four hour run test for the emergency generator conducted within the last 36 months. | SS=F |
Report Facts
Certified beds: 42
Census: 39
Deficiencies cited: 4
Generator load test duration: 3.5
Residents affected: 15
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Max Jones | Administrator | Named in relation to review of findings and exit conference |
| Director of Environmental Services | Interviewed and acknowledged generator testing deficiencies and exit door lock issues |
Inspection Report
Renewal
Census: 37
Capacity: 57
Deficiencies: 8
Jun 3, 2024
Visit Reason
This visit was for a Recertification and State Licensure Survey, including a State Residential Licensure Survey conducted on May 28, 29, 30, 31, and June 3, 2024.
Findings
The facility was found deficient in multiple areas including resident self-administration of medications, quality of care related to skin conditions and pressure ulcers, fall prevention interventions, nurse staffing postings, infection prevention and control, fire and disaster preparedness, and service plan documentation. Corrective actions and education were planned with completion dates by June 21, 2024.
Severity Breakdown
SS=D: 5
SS=C: 1
Deficiencies (8)
| Description | Severity |
|---|---|
| Failed to ensure residents were assessed for self-administration of medications and had physician's orders for self-administration for 2 residents. | SS=D |
| Failed to ensure an area of discoloration was assessed and monitored for 1 resident with skin conditions. | SS=D |
| Failed to ensure orders for pressure ulcer dressing were specific and dressings were in place per physician's orders for 1 resident. | SS=D |
| Failed to ensure fall interventions were in place for 1 resident at risk for falls. | SS=D |
| Failed to post current daily nurse staffing information as required. | SS=C |
| Failed to ensure a resident with a chronic wound was placed in enhanced barrier precautions and no staff education was provided. | SS=D |
| Failed to invite the fire department to participate in fire drills every six months as required. | — |
| Failed to ensure the Service Plan was signed by the resident and updated to reflect changes in therapy services for 1 resident. | — |
Report Facts
Survey dates: 5
Resident census: 37
Total capacity: 57
Deficiency counts: 8
Falls: 3
Pressure ulcer measurements: 1.5
Pressure ulcer measurements: 0.5
Therapy sessions: 12
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Max Jones | Administrator | Signed the inspection report |
| Director of Nursing | Interviewed regarding medication self-administration and wound care | |
| Assistant Director of Nursing | Interviewed regarding nurse staffing posting and infection control | |
| RN 1 | Interviewed regarding fall prevention and wheelchair Dycem | |
| LPN 1 | Interviewed regarding enhanced barrier precautions | |
| Maintenance Director | Interviewed regarding fire drill invitations |
Inspection Report
Complaint Investigation
Deficiencies: 0
Feb 6, 2024
Visit Reason
Paper compliance review to the Investigation of Complaint IN00423481 completed on December 28, 2023.
Findings
Parkview Haven was found to be in compliance with 42 CFR Part 483, Subpart B and 410 IAC 16.2-3.1 regarding the paper compliance review to the complaint investigation.
Complaint Details
Investigation of Complaint IN00423481; paper compliance review found facility in compliance.
Inspection Report
Complaint Investigation
Census: 51
Deficiencies: 2
Dec 27, 2023
Visit Reason
This visit was conducted for the investigation of complaints IN00423481 and IN00424317, including a COVID-19 Focused Infection Control Survey.
Findings
The facility was found to have substantiated abuse involving a staff member physically and verbally abusing Resident B, including forceful attempts to pry medication from the resident's hand, pressing fingers into the resident's neck, and yelling foul language. The facility also failed to report the abuse allegation to the Administrator in a timely manner.
Complaint Details
Complaint IN00423481 was substantiated with federal/state deficiencies cited at F600 and F609 related to abuse and failure to timely report. Complaint IN00424317 had no deficiencies cited.
Severity Breakdown
SS=D: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Failure to ensure a resident was free from verbal and physical abuse by a staff member. | SS=D |
| Failure to report an allegation of abuse to the Administrator in a timely manner. | SS=D |
Report Facts
Census: 51
SNF/NF beds: 30
Residential beds: 21
Medicare residents: 2
Medicaid residents: 11
Other payor residents: 17
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Max Wayern Jones | Administrator | Signed report and referenced in findings |
| Terminated Employee 1 | Staff member substantiated for abuse of Resident B | |
| Employee 2 | Witnessed and reported abuse incident | |
| Employee 3 | Interviewed resident and reported incident to ADON | |
| Employee 4 | Witnessed yelling and water on floor near Nurses' Station | |
| Assistant Director of Nursing | ADON | Interviewed and involved in investigation and reporting |
Inspection Report
Life Safety
Census: 35
Capacity: 42
Deficiencies: 0
Jun 21, 2023
Visit Reason
A Post Survey Revisit (PSR) to the Life Safety Code Recertification and State Licensure Survey was conducted to verify compliance with fire safety and licensure requirements.
Findings
Parkview Haven was found in compliance with the Requirements for Participation in Medicare/Medicaid and the 2012 Life Safety Code. The facility is fully sprinklered except for a detached maintenance garage, and has a fire alarm system and emergency generator.
Inspection Report
Life Safety
Census: 41
Capacity: 42
Deficiencies: 5
May 3, 2023
Visit Reason
An Emergency Preparedness Survey and a Life Safety Code Recertification and State Licensure Survey were conducted by the Indiana Department of Health in accordance with federal regulations.
Findings
The facility was found in compliance with Emergency Preparedness Requirements but was not in compliance with Life Safety Code requirements. Deficiencies were identified related to kitchen fire suppression system hydrostatic testing, sprinkler system maintenance and testing, ceiling construction near sprinklers, sprinkler head cleanliness, and corridor door latching.
Severity Breakdown
SS=E: 1
SS=C: 1
SS=D: 3
Deficiencies (5)
| Description | Severity |
|---|---|
| Failed to maintain kitchen commercial cooking equipment suppression system hydrostatic test as required by NFPA 96. | SS=E |
| Failed to maintain 2 of 2 sprinkler systems in accordance with NFPA 25; missing inspection documentation for May to October 2022. | SS=C |
| Failed to maintain ceiling construction in 1 of 5 smoke compartments causing potential sprinkler operation issues. | SS=D |
| Failed to ensure 5 of 11 sprinkler heads were free of dirt, dust, and loading. | SS=D |
| Failed to ensure 2 of 10 resident room corridor doors latched properly to resist passage of smoke. | SS=D |
Report Facts
Certified beds: 42
Census: 41
Residents affected by door latching deficiency: 4
Residents potentially affected by kitchen suppression deficiency: 15
Residents potentially affected by sprinkler head deficiency: 15
Residents potentially affected by ceiling construction deficiency: 20
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Maintenance Technician #1 | Interviewed and acknowledged deficiencies related to fire suppression system, sprinkler system, ceiling construction, sprinkler heads, and door latching. |
Inspection Report
Complaint Investigation
Census: 16
Capacity: 52
Deficiencies: 8
Apr 11, 2023
Visit Reason
This visit was for a Recertification and State Licensure Survey and the Investigation of Complaint IN00404821. The complaint investigation found no deficiencies related to the allegations.
Findings
The facility was found deficient in multiple areas including respect and dignity related to uncovered urinary catheter bags, failure to inform residents of complaint rights, inadequate ADL care for dependent residents, failure to monitor skin discolorations, improper oxygen administration, infection prevention and control deficiencies, incomplete wound care orders, and incomplete COVID-19 vaccination policies for staff.
Complaint Details
Complaint IN00404821 was investigated and no deficiencies related to the allegations were cited.
Severity Breakdown
SS=D: 5
SS=C: 2
SS=E: 1
Deficiencies (8)
| Description | Severity |
|---|---|
| Failure to maintain resident dignity related to uncovered urinary catheter bag for 1 of 1 residents reviewed. | SS=D |
| Failure to ensure residents were informed of their right to formally complain to the Indiana Department of Health and given contact information. | SS=C |
| Failure to provide necessary ADL care including facial hair removal and nail care for 1 of 1 residents reviewed. | SS=D |
| Failure to monitor and assess skin discolorations for 2 of 4 residents reviewed. | SS=D |
| Failure to ensure proper oxygen administration flow rate for 1 of 1 residents reviewed. | SS=D |
| Failure to ensure infection control guidelines were in place and implemented, including inaccurate employee COVID-19 test documentation, lack of COVID-19 positive resident care policy, and improper hand hygiene during medication pass. | SS=E |
| Failure to develop and implement comprehensive COVID-19 vaccination policies including mitigation plans for unvaccinated employees. | SS=C |
| Failure to ensure treatment orders were in place and implemented for a resident with a pressure ulcer. | — |
Report Facts
Survey dates: 6
Residents present: 16
Total licensed capacity: 52
Residents affected: 1
Residents affected: 1
Residents affected: 2
Residents affected: 1
Residents affected: 36
Inspection Report
Renewal
Deficiencies: 0
Apr 11, 2023
Visit Reason
Paper compliance review to the Recertification and State Licensure Survey completed on April 11, 2023.
Findings
Parkview Haven was found to be in compliance with 42 CFR Part 483, Subpart B and 410 IAC 16.2-3.1 regarding the paper compliance review to the Recertification and State Licensure Survey.
Inspection Report
Complaint Investigation
Census: 46
Deficiencies: 0
Oct 19, 2022
Visit Reason
This visit was conducted for the investigation of Complaint IN00391932.
Findings
The complaint was substantiated, but no deficiencies related to the allegations were cited. The facility was found to be in compliance with relevant regulations.
Complaint Details
Complaint IN00391932 was substantiated; however, no deficiencies related to the allegations were cited.
Report Facts
Census Bed Type - SNF/NF: 32
Census Bed Type - SNF: 1
Census Bed Type - Residential: 13
Census Bed Type - Total: 46
Census Payor Type - Medicare: 7
Census Payor Type - Medicaid: 12
Census Payor Type - Other: 14
Census Payor Type - Total: 33
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