Inspection Reports for Plainfield Health Care Center
3700 CLARKS CREEK RD, PLAINFIELD, IN, 46168
Back to Facility ProfileInspection Report Summary
The most recent inspection on June 24, 2025, found no deficiencies related to the complaint investigated. Prior inspections showed a mixed pattern with several citations mainly involving Life Safety Code violations, resident care issues, medication management, and documentation. Earlier complaints substantiated deficiencies related to resident supervision, wound care, medication errors, and misappropriation of property, but enforcement actions such as fines or license suspensions were not listed in the available reports. Most complaint investigations were unsubstantiated or found no deficiencies, though some substantiated cases involved delayed care and safety concerns. The facility’s recent inspections indicate improvement, with the latest surveys showing compliance after previous citations.
Deficiencies (last 4 years)
Deficiencies (over 4 years)
15.5 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
269% worse than Indiana average
Indiana average: 4.2 deficiencies/yearDeficiencies per year
12
9
6
3
0
Census
Latest occupancy rate
100% occupied
Based on a June 2025 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Occupancy over time
Inspection Report
Complaint Investigation
Census: 103
Capacity: 103
Deficiencies: 0
Date: Jun 24, 2025
Visit Reason
This visit was conducted for the investigation of Complaint IN00459537.
Complaint Details
Complaint IN00459537 was investigated and found to have no deficiencies related to the allegations.
Findings
No deficiencies related to the allegations in Complaint IN00459537 were cited. The facility was found to be in compliance with relevant regulations.
Report Facts
Census Bed Type: 103
Census Payor Type - Medicare: 1
Census Payor Type - Medicaid: 81
Census Payor Type - Other: 21
Inspection Report
Re-Inspection
Census: 106
Capacity: 189
Deficiencies: 0
Date: Jun 12, 2025
Visit Reason
A Post Survey Revisit (PSR) to the Life Safety Code Recertification and State Licensure Survey conducted on 04/28/2025 was performed to verify compliance with life safety code requirements.
Findings
Plainfield Health Care Center was found in compliance with Medicare/Medicaid participation requirements, the Life Safety Code from Fire, and applicable state regulations. The facility was fully sprinklered with appropriate fire alarm and smoke detection systems.
Inspection Report
Complaint Investigation
Census: 112
Capacity: 112
Deficiencies: 0
Date: Apr 30, 2025
Visit Reason
This visit was conducted for the investigation of Complaint IN00457861.
Complaint Details
Complaint IN00457861 was investigated and found to have no deficiencies related to the allegations.
Findings
No deficiencies related to the allegations in Complaint IN00457861 were cited. The facility was found to be in compliance with applicable regulations.
Report Facts
Medicare census: 6
Medicaid census: 83
Other payor census: 23
Inspection Report
Life Safety
Census: 112
Capacity: 189
Deficiencies: 9
Date: Apr 28, 2025
Visit Reason
A Life Safety Code Recertification and State Licensure Survey was conducted by the Indiana Department of Health in accordance with 42 CFR 483.90(a) and NFPA 101 standards.
Findings
The facility was found not in compliance with several Life Safety Code requirements including egress door accessibility, emergency lighting testing, smoke alarm maintenance, hazardous area door self-closing devices, kitchen hood extinguishing system appliance placement, fire alarm system date/time accuracy, sprinkler system inspection documentation, electrical panel security, laundry room electrical safety, and patient care related electrical equipment maintenance.
Deficiencies (9)
Failed to ensure means of egress through 2 of 7 exits were readily accessible; exit doors were magnetically locked without posted code.
Failed to ensure 5 battery backup lights were tested monthly and annually with documentation.
Failed to ensure documentation for preventative maintenance of 94 battery operated smoke alarms in resident rooms was complete.
Failed to ensure corridor door to hazardous area (Medical Records office) had self-closing device.
Failed to provide approved method for returning cooking appliances to approved design location under kitchen hood extinguishing system.
Failed to maintain fire alarm system with accurate time and date information.
Failed to document sprinkler system inspections as required by NFPA 25.
Failed to ensure all electrical panels in corridors were secured from non-authorized personnel; exposed wires in laundry room junction box.
Failed to conduct required maintenance and maintain documentation for Patient Care Related Electrical Equipment (PCREE).
Report Facts
Certified beds: 189
Census: 112
Battery operated smoke alarms: 94
Battery backup lights: 5
Residents potentially affected by egress door deficiency: 24
Staff potentially affected by egress door deficiency: 6
Visitors potentially affected by egress door deficiency: 3
Staff potentially affected by hazardous area door deficiency: 10
Residents potentially affected by kitchen hood appliance deficiency: 32
Staff potentially affected by kitchen hood appliance deficiency: 6
Visitors potentially affected by kitchen hood appliance deficiency: 2
Residents potentially affected by electrical panel deficiency: 28
Staff potentially affected by electrical panel deficiency: 6
Visitors potentially affected by electrical panel deficiency: 2
Staff potentially affected by laundry room electrical deficiency: 10
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Laura Burton | Administrator | Facility Administrator present at exit conference. |
| Maintenance Director | Named in multiple findings related to maintenance deficiencies and corrective actions. | |
| Visiting Maintenance Director | Participated in observations and interviews during survey. |
Inspection Report
Annual Inspection
Census: 114
Capacity: 114
Deficiencies: 10
Date: Apr 7, 2025
Visit Reason
This visit was for a Recertification and State Licensure Survey, including the Investigation of Complaints IN00455987 and IN00456156.
Complaint Details
Complaints IN00455987 and IN00456156 were investigated with no deficiencies related to the allegations cited.
Findings
The facility was found deficient in multiple areas including inadequate nursing staff leading to delayed ADL care, failure to notify ombudsman of resident transfer, inaccurate MDS assessments, failure to update care plans after medication changes, inadequate ADL care for dependent residents, improper bowel incontinence management, expired and undated insulin medications, and failure to ensure COVID-19 vaccination for a resident.
Deficiencies (10)
Failure to ensure adequate nursing and laundry staff to provide timely ADL care and assistance.
Failure to notify the ombudsman of a resident transfer to hospital.
Failure to notify resident or representative of bed hold policy upon transfer.
Inaccurate Minimum Data Set (MDS) assessments for multiple residents.
Failure to maintain PASARR documentation for a resident with major mental illness.
Failure to update care plan after medication changes for a resident.
Failure to provide adequate ADL care for dependent residents, including hygiene and grooming.
Failure to provide appropriate treatment for bowel incontinence related to antibiotic use.
Failure to date insulin pens and presence of expired insulin vial in medication storage.
Failure to ensure resident was vaccinated against COVID-19 or properly documented.
Report Facts
Residents present: 114
Total licensed capacity: 114
Medicare residents: 7
Medicaid residents: 83
Other residents: 24
Deficiency counts: 10
Staffing hours per resident: 0.3
Staffing hours per resident: 0.2
Staffing hours per resident: 0.6
Staffing hours per resident: 0.3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Laura Burton | Administrator | Signed the inspection report |
| LPN 17 | Licensed Practical Nurse | Provided information about bowel incontinence and wound care for Resident 366 |
| NP 15 | Nurse Practitioner | Provided information about Resident 366's diarrhea and treatment |
| LPN 13 | Nurse Manager | Provided information about stool softener use and diarrhea management |
| Regional Nurse Consultant | Consultant | Provided facility policies and interview information |
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Apr 7, 2025
Visit Reason
Paper compliance review to the Recertification and State Licensure Survey completed on April 7, 2025.
Findings
Plainfield Health Care Center was found to be in compliance with 42 CFR Part 483, Subpart B and 410 IAC 16.2-3.1 in regard to the paper compliance review to the Recertification and State Licensure Survey.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Mar 21, 2025
Visit Reason
Paper compliance review to the Investigation of Complaints IN00449428, IN00453464, and IN00453723 completed on February 20, 2025.
Findings
Plainfield Health Care Center was found to be in compliance with 42 CFR Part 483, Subpart B and 410 IAC 16.2-3.1 in regard to the paper compliance review of the investigations.
Report Facts
Complaint Investigations: 3
Inspection Report
Complaint Investigation
Census: 108
Capacity: 108
Deficiencies: 0
Date: Mar 11, 2025
Visit Reason
This visit was conducted for the investigation of Complaint IN00454529.
Complaint Details
Complaint IN00454529 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 relevant regulations.
Report Facts
Medicare census: 6
Medicaid census: 77
Other payor census: 25
Inspection Report
Complaint Investigation
Census: 107
Capacity: 107
Deficiencies: 6
Date: Feb 20, 2025
Visit Reason
Investigation of multiple complaints alleging misappropriation of property and other concerns at Plainfield Health Care Center.
Complaint Details
Multiple complaints (IN00446484, IN00449428, IN00451783, IN00451862, IN00452158, IN00452303, IN00452675, IN00452714, IN00453379, IN00453464, IN00453723) were investigated. Deficiencies related to misappropriation of property and medication errors were substantiated in complaints IN00449428 and IN00453464.
Findings
The facility failed to protect a resident from misappropriation of property by a former staff member, failed to report and investigate the alleged crime timely, and failed to ensure medication safety and proper medication disposition. Additionally, a QMA worked with an expired license.
Deficiencies (6)
Failed to protect resident's right to be free from misappropriation of property related to unauthorized use of debit card by a former Social Service Assistant.
Failed to implement policies and procedures for reporting reasonable suspicion of a crime in accordance with federal requirements.
Failed to thoroughly investigate an allegation of misappropriation of property.
Resident found with two transdermal medication patches applied simultaneously, constituting a significant medication error.
Failed to complete admission inventory and discharge medication count/documentation for a resident.
Failed to assure a valid license before a Qualified Medication Aide provided medication and treatment services.
Report Facts
Census: 107
Total Capacity: 107
Debit Card Charges: 4000
QMA Work Days with Expired License: 59
Rivastigmine Patch Dosage: 12.3
Rivastigmine Patch Dosage: 13.3
Clonazepam Count: 43
Employees mentioned
| Name | Title | Context |
|---|---|---|
| QMA 10 | Qualified Medication Aide | Worked passing medications with expired license from July 2024 to October 2024. |
| Laura Burton | Administrator | Named in relation to investigation and response to Resident B's misappropriation complaint. |
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Nov 21, 2024
Visit Reason
Paper compliance review to the Investigation of Complaints IN00445177, IN00445565, IN00445570, and IN00445476 completed on October 25, 2024.
Complaint Details
The visit was related to complaint investigations IN00445177, IN00445565, IN00445570, and IN00445476; the facility was found in compliance.
Findings
Plainfield Health Care Center 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 of the investigations.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Nov 21, 2024
Visit Reason
Paper compliance review to the Investigation of Complaints IN00441980, IN00441976, and IN00442404 completed on September 6, 2024.
Complaint Details
Investigation of Complaints IN00441980, IN00441976, and IN00442404 were reviewed for paper compliance.
Findings
Plainfield Health Care Center was found to be in compliance with 42 CFR Part 483, Subpart B and 410 IAC 16.2-3.1 in regard to the paper compliance review of the investigations.
Inspection Report
Complaint Investigation
Census: 107
Capacity: 107
Deficiencies: 3
Date: Oct 23, 2024
Visit Reason
This visit was conducted for the investigation of multiple complaints (IN00445177, IN00445565, IN00445570, and IN00445476) concerning resident care and safety issues at Plainfield Health Care Center.
Complaint Details
The investigation involved complaints IN00445177, IN00445565, IN00445570, and IN00445476. The complaints included failure to notify family of wounds, failure to implement wound care plans, and improper handling of a resident fall resulting in injury. The complaints were substantiated with deficiencies cited accordingly.
Findings
The facility was found deficient in notifying a resident's representative of a left hip wound, failing to implement care plan interventions to prevent wound development, and not properly managing a resident fall which resulted in a hip fracture. Deficiencies were cited related to notification of changes, care planning, and quality of care.
Deficiencies (3)
Failed to ensure the resident's representative was notified of a left hip wound for 1 of 3 residents reviewed for wounds (Resident C).
Failed to implement care plan interventions to prevent further development of wounds for 1 of 3 residents reviewed for wounds (Resident C).
Failed to ensure a resident who fell was not moved before seeking treatment and was subsequently diagnosed with a hip fracture for 1 of 3 residents reviewed for accidents (Resident B).
Report Facts
Census: 107
Total Capacity: 107
Medicare Census: 6
Medicaid Census: 85
Other Payor Census: 16
Fall Risk Score: 14
Pain Scale: 10
Wound Size: 1
Wound Size: 0.5
Wound Size: 2
Wound Size: 0.8
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Laura Burton | Administrator | Signed the inspection report |
| Not fully named | Director of Nursing (DON) | Interviewed regarding wound notification and fall management; no full name provided |
| Not fully named | Assistant Director of Nursing (ADON) | Interviewed regarding fall response procedures; no full name provided |
| Not fully named | Nurse Practitioner (NP) | Involved in wound care orders and fall evaluation; no full name provided |
| Not fully named | Licensed Practical Nurse (LPN 8) | Documented fall and communicated with NP; no full name provided |
Inspection Report
Complaint Investigation
Census: 112
Capacity: 112
Deficiencies: 3
Date: Sep 6, 2024
Visit Reason
This visit was for the investigation of complaints IN00441980, IN00441976, and IN00442404 regarding federal/state deficiencies related to resident care and facility practices.
Complaint Details
The investigation was triggered by complaints IN00441980, IN00441976, and IN00442404. The complaints alleged failures in notification of changes in condition, respiratory care orders, and medication administration for Resident B. The complaints were substantiated with deficiencies cited at F580, F695, and F755.
Findings
The facility failed to notify the responsible party of a resident's change in condition, failed to ensure respiratory services orders were properly obtained and documented, and failed to provide medications as ordered by the physician for one resident. These deficiencies were related to complaints and involved Resident B's care, including notification failures, respiratory care, and medication administration.
Deficiencies (3)
Failed to notify the responsible party of a change in condition for Resident B.
Failed to ensure respiratory services order was obtained and entered into the medical record for Resident B.
Failed to ensure medications were provided as ordered by the physician for Resident B.
Report Facts
Census: 112
Total Capacity: 112
Medicare Census: 3
Medicaid Census: 80
Other Payor Census: 29
Deficiency Severity Count: 3
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Sep 4, 2024
Visit Reason
The document is a paper compliance review related to the Investigation of Complaints IN00438940, IN00437780, IN00437783, IN00437462, and IN00432231 completed on July 19, 2024.
Findings
Plainfield Health Care Center 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 of the listed investigations.
Inspection Report
Complaint Investigation
Census: 100
Capacity: 100
Deficiencies: 3
Date: Jul 17, 2024
Visit Reason
This visit was for the investigation of multiple complaints alleging deficiencies related to quality of care, supervision, and pest control at Plainfield Health Care Center.
Complaint Details
This investigation was triggered by multiple complaints (IN00438940, IN00438234, IN00438150, IN00437780, IN00437783, IN00437462, IN00436746, IN00435654, IN00432231) alleging quality of care issues, inadequate supervision, and pest control problems. Some complaints were substantiated with deficiencies cited, others were not.
Findings
The facility was found deficient in providing timely and effective care to a resident with an ileostomy leading to severe skin breakdown and hospitalization, failed to provide adequate supervision to a resident resulting in a fall during showering, and had an ineffective pest control program evidenced by persistent flying insects throughout the building.
Deficiencies (3)
Failure to ensure timely assessment, skin care, and monitoring for a resident with an ileostomy resulting in severe skin breakdown and hospitalization.
Failure to provide adequate supervision for a resident during showering resulting in a fall and fatal head injury.
Failure to maintain an effective pest control program resulting in persistent flying insects throughout the facility including kitchen and dining areas.
Report Facts
Residents present: 100
Licensed capacity: 100
Medicare census: 5
Medicaid census: 80
Number of showers Resident C had: 4
Date of survey completion: Jul 19, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Laura Burton | Administrator | Signed the report |
| RN 21 | Registered Nurse | Involved in Resident C fall incident and assessment |
| LPN 17 | Licensed Practical Nurse | Provided care to Resident G on day of discharge |
| CNA 12 | Certified Nursing Assistant | Reported Resident C showering alone and fall incident |
| Assistant Director of Nursing | ADON | Interviewed regarding Resident G and Resident C care and fall |
| Maintenance Supervisor | Maintenance Supervisor | Provided information on pest control efforts and chemical use |
| Dietary Manager | Dietary Manager | Provided information on kitchen cleanliness and pest control |
| Pest Technician | Pest Control Technician | Provided pest control service and assessment |
Inspection Report
Follow-Up
Census: 106
Capacity: 106
Deficiencies: 0
Date: Apr 23, 2024
Visit Reason
This visit was a Post Survey Revisit (PSR) to the Investigation of Complaint IN00430651 completed on March 22, 2024.
Complaint Details
Complaint IN00430651 was investigated and found to be corrected.
Findings
Plainfield Health Care Center was found to be in compliance with 42 CFR Part 483 Subpart B and 410 IAC 16.2-3.1 in regard to the PSR to the Investigation of Complaint IN00430651.
Report Facts
Census SNF/NF: 106
Total Capacity: 106
Census Payor Type Medicare: 5
Census Payor Type Medicaid: 88
Census Payor Type Other: 13
Inspection Report
Re-Inspection
Census: 105
Capacity: 189
Deficiencies: 0
Date: Apr 18, 2024
Visit Reason
A Post Survey Revisit (PSR) to the Life Safety Code Recertification and State Licensure Survey conducted on 02/27/24 was performed to verify compliance with fire safety and licensure requirements.
Findings
The facility was found in compliance with Requirements for Participation in Medicare/Medicaid, Life Safety from Fire, and the 2012 edition of the National Fire Protection Association (NFPA) 101, Life Safety Code. The facility is fully sprinklered with appropriate smoke detection systems in place.
Report Facts
Facility capacity: 189
Census: 105
Inspection Report
Complaint Investigation
Census: 102
Capacity: 102
Deficiencies: 3
Date: Mar 22, 2024
Visit Reason
Investigation of Complaints IN00430638 and IN00430651, resulting in a Partially Extended Survey due to Substandard Quality of Care - Immediate Jeopardy.
Complaint Details
Complaint IN00430638 had no deficiencies related to the allegations. Complaint IN00430651 resulted in federal/state deficiencies cited at F609, F689, and F744 related to the resident elopement incident and quality of care.
Findings
The facility failed to ensure accurate reporting of a resident elopement incident and failed to provide adequate supervision and individualized dementia care for a cognitively impaired resident who exited a second story window, resulting in multiple fractures. The resident's care plan and assessments were incomplete, and staff failed to notify appropriate personnel of exit-seeking behaviors. Immediate jeopardy was identified and later removed after corrective actions were implemented.
Deficiencies (3)
Failure to ensure accurate reporting of alleged violations related to a resident elopement incident.
Failure to provide effective supervision to prevent a cognitively impaired resident from exiting a second story window, resulting in serious injuries.
Failure to provide individualized dementia care and supervision for a newly admitted resident with Alzheimer's dementia, resulting in elopement and injury.
Report Facts
Census: 102
Total Capacity: 102
Survey Dates: 4
Resident Injuries: 5
Gait Belt Length: 2
Window Height: 13
Employees mentioned
| Name | Title | Context |
|---|---|---|
| William McCallum | Administrator | Administrator who signed the report and participated in exit conference |
| LPN 5 | Licensed Practical Nurse | Observed resident outside, initiated elopement protocol, and reported incident |
| LPN 6 | Licensed Practical Nurse | Direct nurse for Resident B, involved in resident care and elopement event |
| LPN 11 | Licensed Practical Nurse | Documented resident's exit seeking behavior and interactions on 3/16/24 |
| CNA 7 | Certified Nursing Aide | Assisted in searching for Resident B during elopement |
| CNA 8 | Certified Nursing Aide | Assisted in searching for Resident B during elopement |
| CNA 9 | Certified Nursing Aide | Observed resident's behaviors and reported window opened on porch |
| Director of Nursing | Director of Nursing | Provided information on resident care and elopement care plan |
| Memory Care Social Services | Social Services | Provided information on resident admission and unit placement |
Inspection Report
Life Safety
Census: 104
Capacity: 189
Deficiencies: 4
Date: Feb 27, 2024
Visit Reason
A Life Safety Code Recertification and State Licensure Survey was conducted by the Indiana Department of Health in accordance with 42 CFR 483.90(a) to assess compliance with Life Safety from Fire and related regulations.
Findings
The facility was found not in compliance with Life Safety Code requirements, including expired inspection certificates for 10 fuel fired water heaters, a set of smoke barrier doors that did not close properly, and unsecured electrical outlets and panels. Corrective actions and plans of correction were documented with compliance dates in March 2024.
Deficiencies (4)
Failed to ensure 10 of 10 fuel fired water heaters had current inspection certificates.
Failed to ensure 1 of 8 sets of smoke barrier doors would close to form a smoke resistant barrier.
Failed to ensure 1 of over 100 electrical outlets were maintained in a safe operating condition with exposed wires.
Failed to ensure all electrical panels in corridors were secured from non-authorized personnel.
Report Facts
Certified beds: 189
Census: 104
Fuel fired water heaters: 10
Smoke barrier doors: 8
Electrical outlets: 100
Electrical panels: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mac McCallum | RDO | Laboratory Director or Provider/Supplier Representative who signed the report |
| Maintenance Director | Interviewed regarding deficiencies and corrective actions for water heaters, smoke barrier doors, and electrical issues |
Inspection Report
Annual Inspection
Census: 103
Capacity: 103
Deficiencies: 9
Date: Feb 15, 2024
Visit Reason
This visit was for a Recertification and State Licensure Survey conducted from February 8 to 15, 2024.
Findings
The facility was found deficient in multiple areas including medication self-administration assessments, resident privacy during care, PASARR coordination, care plan revisions, activity programming, accident prevention related to wheelchair brakes, Foley catheter care, enteral feeding labeling, and food safety practices.
Deficiencies (9)
Failed to ensure medications were not left in resident's room without proper supervision and/or a medication self-administration assessment for 3 of 9 residents.
Failed to ensure a resident had the right to privacy during a wound dressing treatment for 1 of 1 resident reviewed for privacy.
Failed to ensure a new Level of Care screen was submitted for a resident after an in-patient psychiatric hospital stay with new mental health diagnoses.
Failed to ensure comprehensive care plans were reviewed and revised in a timely manner to reflect residents' advance directive wishes for 3 of 5 residents.
Failed to ensure meaningful activities were provided and implemented as scheduled, failed to invite additional residents to activities, and failed to document participation for residents on the secured memory care unit.
Failed to prevent potential accidents by effectively monitoring and maintaining anti-roll back brake systems on wheelchairs for 3 of 9 residents reviewed for accidents.
Failed to ensure Foley catheters were not on the floor and that dignity covers were used for 2 of 3 residents observed for urinary collection devices.
Failed to ensure enteral nutrition formula was correctly labeled for 1 of 1 resident reviewed for tube feeding management.
Failed to ensure staff providing assistance with eating followed infection control guidelines for 2 of 2 residents and failed to ensure all foods were dated in the kitchen for 1 of 2 kitchen observations.
Report Facts
Census: 103
Total Capacity: 103
Medicare Census: 7
Medicaid Census: 74
Other Payor Census: 22
Deficiencies cited: 9
Tube feeding rate: 55
Tube feeding volume fed: 1972
Employees mentioned
| Name | Title | Context |
|---|---|---|
| William E Mccallum | Regional Director of Operations | Signed the report |
| RN 23 | Registered Nurse | Named in enteral feeding labeling deficiency |
| RN 21 | Registered Nurse | Named in enteral feeding labeling deficiency |
| QMA 17 | Qualified Medical Aide | Named in infection control deficiency during feeding assistance |
| CNA 18 | Certified Nursing Aide | Named in infection control deficiency during feeding assistance |
| Director of Nursing | Director of Nursing | Interviewed and involved in multiple findings and corrective actions |
| Memory Care Director | Memory Care Director | Interviewed and involved in activity and care plan findings |
| Assistant Director of Nursing | Assistant Director of Nursing | Observed during privacy and accident prevention findings |
Inspection Report
Renewal
Deficiencies: 0
Date: Feb 15, 2024
Visit Reason
The visit was a paper compliance review related to the Recertification and Licensure Survey completed on February 15, 2024.
Findings
Plainfield Health Care Center 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 for the Recertification and Licensure Survey.
Inspection Report
Complaint Investigation
Census: 102
Deficiencies: 0
Date: Jan 30, 2024
Visit Reason
This visit was conducted for the investigation of Complaint IN00426137.
Complaint Details
Complaint IN00426137 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 applicable regulations.
Report Facts
Census: 102
Census Bed Type - SNF: 11
Census Bed Type - SNF/NF: 91
Census Payor Type - Medicare: 8
Census Payor Type - Medicaid: 65
Census Payor Type - Other: 29
Inspection Report
Complaint Investigation
Census: 96
Capacity: 96
Deficiencies: 0
Date: Aug 3, 2023
Visit Reason
This visit was conducted for the investigation of Complaint IN00413968.
Complaint Details
Complaint IN00413968 was investigated and found to have no deficiencies related to the allegation.
Findings
No deficiencies related to the complaint allegation were cited. The facility was found to be in compliance with applicable regulations.
Report Facts
Medicare residents: 6
Medicaid residents: 75
Other residents: 15
Inspection Report
Complaint Investigation
Census: 89
Capacity: 89
Deficiencies: 0
Date: Jul 6, 2023
Visit Reason
This visit was conducted for the investigation of Complaint IN00410161.
Complaint Details
Complaint IN00410161 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 applicable regulations.
Report Facts
Medicare census: 4
Medicaid census: 74
Other payor census: 11
Inspection Report
Life Safety
Census: 85
Capacity: 189
Deficiencies: 0
Date: Mar 23, 2023
Visit Reason
A 2nd Post Survey Revisit (PSR) to the Life Safety Code PSR Survey that exited on 03/02/23 for the Life Safety Code Annual Recertification survey that exited on 01/05/23 was conducted by the Indiana Department of Health.
Findings
At this PSR survey, Plainfield Health Care Center was found in compliance with Requirements for Participation in Medicare/Medicaid, Life Safety from Fire, and the 2012 edition of the National Fire Protection Association (NFPA) 101, Life Safety Code (LSC), Chapter 19, Existing Health Care Occupancies and 410 IAC 16.2. The facility was fully sprinklered with appropriate fire alarm and smoke detection systems.
Report Facts
Facility capacity: 189
Census: 85
Inspection Report
Re-Inspection
Census: 85
Capacity: 189
Deficiencies: 2
Date: Mar 2, 2023
Visit Reason
A Post Survey Revisit (PSR) to the Life Safety Code Recertification and State Licensure Survey conducted on 01/05/23 was conducted to verify compliance with previous deficiencies.
Findings
The facility was found not in compliance with Life Safety Code requirements due to obstructions in one means of egress and the use of prohibited portable space heaters. Immediate interventions were taken to remove the obstructions and heaters, and plans for ongoing monitoring were established.
Deficiencies (2)
Failed to ensure 1 of 7 means of egress were continuously maintained free of all obstructions or impediments to full instant use in case of fire or emergency.
Failed to ensure 2 of 2 portable space heaters were not used in the facility, violating policy and safety codes.
Report Facts
Residents affected: 18
Residents affected: 26
Deficiencies cited: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Mac McCallum | Regional Director of Ops | Signed report and involved in exit conference. |
| Regional Maintenance Director | Interviewed and acknowledged deficiencies during survey. | |
| Maintenance Director | Interviewed and acknowledged deficiencies during survey. |
Inspection Report
Complaint Investigation
Census: 89
Capacity: 89
Deficiencies: 0
Date: Feb 6, 2023
Visit Reason
This visit was conducted for the investigation of complaints IN00398412 and IN00400589.
Complaint Details
Complaint IN00398412 - Substantiated with no deficiencies cited. Complaint IN00400589 - Unsubstantiated due to lack of evidence.
Findings
Complaint IN00398412 was substantiated but no deficiencies related to the allegations were cited. Complaint IN00400589 was unsubstantiated due to lack of evidence. The facility was found to be in compliance with relevant regulations.
Report Facts
Census SNF/NF beds: 89
Census total residents: 89
Census Medicare residents: 10
Census Medicaid residents: 63
Census other payor residents: 16
Inspection Report
Re-Inspection
Census: 87
Capacity: 87
Deficiencies: 0
Date: Jan 13, 2023
Visit Reason
This visit was a Post Survey Revisit (PSR) to the Recertification and State Licensure Survey completed on December 6, 2022.
Findings
Plainfield Health Care Center was found to be in compliance with 42 CFR Part 483, Subpart B and 410 IAC 16.2-3.1 in regard to the PSR to the Recertification and State Licensure Survey.
Report Facts
Census Payor Type - Medicare: 10
Census Payor Type - Medicaid: 63
Census Payor Type - Other: 14
Inspection Report
Life Safety
Census: 96
Capacity: 189
Deficiencies: 2
Date: Jan 5, 2023
Visit Reason
A Life Safety Code Recertification and State Licensure Survey was conducted by the Indiana State Department of Health in accordance with 42 CFR 483.90(a) to assess compliance with Life Safety from Fire and related regulations.
Findings
The facility was found not in compliance with NFPA 101 Life Safety Code requirements due to incomplete sprinkler system installation and lack of a reliable fuel source letter for the emergency generator. The sprinkler heads on the Memory Care unit were spaced less than 6 feet apart, and the facility lacked documentation from the natural gas provider confirming reliability of the fuel source.
Deficiencies (2)
Failed to ensure a complete automatic sprinkler system was installed in accordance with NFPA 13, with two sprinkler heads spaced only 44 inches apart on the Memory Care unit.
Failed to ensure the emergency generator had a reliable source of fuel as required by NFPA 101 and NFPA 110, lacking a letter from the natural gas provider confirming reliability.
Report Facts
Certified beds: 189
Census: 96
Sprinkler head spacing: 44
Compliance date for sprinkler correction: Jan 31, 2023
Compliance date for fuel source letter: Jan 31, 2023
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Director of Plant Operations | Interviewed regarding sprinkler head spacing and fuel source letter; acknowledged deficiencies and corrective actions | |
| Regional Maintenance Director | Present during exit conference; no additional information provided |
Inspection Report
Routine
Deficiencies: 8
Date: Dec 6, 2022
Visit Reason
The inspection was a routine survey conducted to assess compliance with Medicare/Medicaid regulations, including review of Medicaid/Medicare coverage notices, accuracy of assessments, nutrition and hydration status, respiratory care, dialysis, meal/snack frequency, infection preventionist qualifications, and personnel licensing.
Findings
The facility was cited for multiple deficiencies including failure to timely provide Medicare Non-Coverage notices, inaccurate Minimum Data Set (MDS) assessments, inadequate nutrition and hydration support resulting in significant weight loss and abnormal labs, lack of physician orders for respiratory care equipment maintenance, failure to perform pre/post dialysis assessments, failure to provide evening snacks when meal intervals exceeded 14 hours, lack of a qualified infection preventionist, and employment of a staff member with an expired license.
Deficiencies (8)
Failed to provide timely Medicare Non-Coverage notices to residents discharged from Medicare Part A stay with benefit days remaining.
Failed to ensure accuracy of Minimum Data Set (MDS) assessments for residents, including incorrect weight loss regimen and PASRR status.
Failed to ensure residents received adequate nutrition and hydration, resulting in significant weight loss and abnormal lab values.
Failed to obtain physician orders for routine care and maintenance of oxygen tubing and bipap equipment for a resident.
Failed to perform and document pre and post dialysis assessments for a resident receiving dialysis.
Failed to provide evening snacks when the time lapse between dinner and breakfast exceeded 14 hours for residents.
Failed to designate a qualified infection preventionist who works at least part-time and has completed specialized training.
Employed a Certified Nursing Aide with an expired license who worked for 13 days after expiration.
Report Facts
Residents reviewed for MDS accuracy: 24
Residents reviewed for PASRR: 6
Residents requiring house shakes weekly: 119
Days CNA worked with expired license: 13
Employees mentioned
| Name | Title | Context |
|---|---|---|
| CNA 29 | Certified Nursing Aide | Worked 13 days after license expired on 11/18/22. |
| QMA 34 | Qualified Medication Aide / Infection Preventionist | Designated as Infection Preventionist but lacked required qualifications and worked part-time. |
| Mac McCallum | Regional Director of Operations | Signed the report. |
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Nov 7, 2022
Visit Reason
Paper compliance review related to the Investigation of Complaint IN00375467 completed on June 8, 2022.
Complaint Details
Investigation of Complaint IN00375467 completed on June 8, 2022; facility found in compliance.
Findings
Plainfield Health Care Center 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 of the complaint investigation.
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