Inspection Report
Complaint Investigation
Census: 102
Deficiencies: 0
Jun 16, 2025
Visit Reason
This visit was conducted for the investigation of Complaints IN00460774 and IN00460778, and included a Post Survey Revisit to Complaint IN00458856.
Findings
No deficiencies related to the allegations in Complaints IN00460774 and IN00460778 were cited. The facility was found to be in compliance with relevant regulations.
Complaint Details
Complaints IN00460774 and IN00460778 were investigated and found to have no deficiencies related to the allegations.
Report Facts
Residential Census: 102
Inspection Report
Follow-Up
Census: 102
Deficiencies: 0
Jun 16, 2025
Visit Reason
This visit was a Post Survey Revisit (PSR) to the Investigation of Complaint IN00458856 completed on May 15, 2025, conducted in conjunction with investigations of Complaints IN00460774 and IN00460778.
Findings
Storypoint Fort Wayne West was found to be in compliance with 410 IAC 16.2-5 regarding the PSR to Investigation of Complaint IN00458856.
Complaint Details
Complaint IN00458856 was corrected; the visit was related to investigations of Complaints IN00458856, IN00460774, and IN00460778.
Inspection Report
Complaint Investigation
Census: 113
Deficiencies: 1
May 15, 2025
Visit Reason
This visit was conducted for the investigation of complaints IN00457858 and IN00458856. Complaint IN00457858 had no deficiencies cited, while complaint IN00458856 resulted in deficiencies related to allegations of physical abuse.
Findings
The facility failed to ensure residents were free from physical abuse for 1 of 3 residents reviewed (Resident B). Video evidence and interviews confirmed that Qualified Medication Aide (QMA) 2 physically abused Resident B by dragging and pushing her into a chair. Staff interviews and policy review supported the findings.
Complaint Details
Complaint IN00458856 was substantiated with deficiencies cited related to physical abuse. Complaint IN00457858 had no deficiencies related to the allegations.
Deficiencies (1)
| Description |
|---|
| Facility failed to ensure residents were free from physical abuse for Resident B, including dragging and pushing by QMA 2. |
Report Facts
Residential Census: 113
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Laura Lovell | Executive Director | Signed the report |
| QMA 2 | Qualified Medication Aide | Named in physical abuse finding involving Resident B |
| QMA 3 | Qualified Medication Aide | Interviewed regarding physical abuse definitions |
| LPN 4 | Licensed Practical Nurse | Interviewed regarding physical abuse definitions and reporting |
| CNA 5 | Certified Nurse Aide | Interviewed regarding physical abuse definitions and reporting |
Inspection Report
Complaint Investigation
Census: 106
Deficiencies: 0
Feb 19, 2025
Visit Reason
This visit was conducted for the investigation of Complaint IN00453492.
Findings
No deficiencies related to the allegations in Complaint IN00453492 were cited. The facility was found to be in compliance with 410 IAC 16.2-5 regarding the complaint.
Complaint Details
Complaint IN00453492 was investigated and found to have no deficiencies related to the allegations.
Inspection Report
Original Licensing
Census: 106
Deficiencies: 0
Feb 13, 2025
Visit Reason
This visit was for a State Residential Licensure Survey conducted on February 12 and 13, 2025.
Findings
Story Point Fort Wayne West 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: 112
Deficiencies: 1
Sep 20, 2024
Visit Reason
This visit was conducted for the investigation of Complaint IN00441940 regarding allegations related to resident care and safety.
Findings
The facility failed to implement adequate interventions to prevent falls for 2 of 3 residents reviewed (Resident B and Resident D). Documentation such as hourly resident location checklists were missing for the dates of the falls, and the facility's policy did not specify the frequency of resident checks to prevent falls.
Complaint Details
Complaint IN00441940 was substantiated with deficiencies cited at R0240 related to fall prevention and documentation failures.
Deficiencies (1)
| Description |
|---|
| Failed to implement interventions to prevent falls for 2 of 3 residents reviewed with falls (Resident B and Resident D). |
Report Facts
Resident census: 112
Number of charts to audit: 33
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Laura Lovell | Executive Director | Signed as provider/supplier representative |
| Director of Nursing | Interviewed regarding resident falls and documentation | |
| Qualified Medication Aide 2 | Interviewed about resident checks and documentation |
Inspection Report
Complaint Investigation
Census: 106
Deficiencies: 0
Aug 15, 2024
Visit Reason
This visit was conducted for the investigation of Complaint IN00440214.
Findings
No deficiencies related to the allegations in Complaint IN00440214 were cited. The facility was found to be in compliance with 410 IAC 16.2-5 regarding the complaint investigation.
Complaint Details
Complaint IN00440214 was investigated and found to have no deficiencies related to the allegations.
Inspection Report
Complaint Investigation
Census: 103
Deficiencies: 0
Jul 22, 2024
Visit Reason
This visit was conducted for the investigation of Complaint IN00438662.
Findings
No deficiencies related to the allegations in Complaint IN00438662 were cited. The facility was found to be in compliance with 410 IAC 16.2-5 regarding the complaint investigation.
Complaint Details
Complaint IN00438662 was investigated and found to have no deficiencies related to the allegations.
Inspection Report
Complaint Investigation
Census: 107
Deficiencies: 0
Jul 11, 2024
Visit Reason
This visit was conducted for the investigation of complaints IN00437351 and IN00438367.
Findings
No deficiencies related to the allegations in complaints IN00437351 and IN00438367 were cited. The facility was found to be in compliance with 410 IAC 16.2-5 regarding these complaints.
Complaint Details
Investigation of Complaints IN00437351 and IN00438367 found no deficiencies related to the allegations; both complaints were not substantiated.
Report Facts
Residential Census: 107
Inspection Report
Complaint Investigation
Census: 109
Deficiencies: 0
Jun 18, 2024
Visit Reason
This visit was conducted for the investigation of Complaint IN00435363.
Findings
No deficiencies related to the allegations in Complaint IN00435363 were cited. The facility was found to be in compliance with 410 IAC 16.2-5 regarding the complaint investigation.
Complaint Details
Complaint IN00435363 was investigated and found to have no deficiencies related to the allegations.
Inspection Report
Complaint Investigation
Census: 103
Deficiencies: 7
May 8, 2024
Visit Reason
This visit was for a State Residential Licensure Survey which included the Investigation of Complaint IN00433376.
Findings
No deficiencies related to the complaint allegations were cited. However, multiple deficiencies were found including lack of CPR and first aid certified staff on duty, expired employee certifications, incomplete employee personnel files, pets without required immunizations, incomplete resident service plans, kitchen sanitation issues, and inadequate documentation related to resident deaths.
Complaint Details
Complaint IN00433376 was investigated and no deficiencies related to the allegations were cited.
Deficiencies (7)
| Description |
|---|
| Failed to ensure a CPR and first aid certified staff member was on duty for 7 of 7 days reviewed. |
| Failed to ensure certification was maintained for 3 of 47 employee certifications reviewed (HHA, QMA, CNA). |
| Failed to maintain current and accurate employee personnel files for 3 of 5 employee files reviewed. |
| Failed to ensure 4 of 8 pets living with residents had required immunizations. |
| Failed to ensure current, signed service plans were completed for 3 of 5 residents reviewed. |
| Failed to ensure labeling of foods, cleanliness of kitchen and equipment. |
| Failed to ensure accurate documentation of resident condition prior to death, disposition of remains and personal belongings for 2 residents. |
Report Facts
Residents present: 103
Employee certifications reviewed: 47
Employee files reviewed: 5
Pets reviewed: 8
Residents reviewed for service plans: 5
Residents with deficient service plans: 3
Residents reviewed for death documentation: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Timothy Daugherty | Administrator | Signed the report |
| Director of Nursing | Provided certification records and interviews regarding staffing and documentation deficiencies | |
| Executive Chef | Interviewed regarding kitchen sanitation deficiencies | |
| Cook 20 | Interviewed regarding kitchen sanitation and cleaning practices |
Inspection Report
Complaint Investigation
Census: 94
Deficiencies: 0
Apr 26, 2024
Visit Reason
This visit was conducted for the investigation of Complaint IN00432629.
Findings
No deficiencies related to the allegations in Complaint IN00432629 were cited. The facility was found to be in compliance with 410 IAC 16.2-5 regarding the complaint investigation.
Complaint Details
Complaint IN00432629 was investigated and found to have no deficiencies related to the allegations.
Inspection Report
Complaint Investigation
Census: 88
Deficiencies: 0
Feb 8, 2024
Visit Reason
This visit was conducted for the investigation of Complaint IN00427039.
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.
Complaint Details
Complaint IN00427039 was investigated and found to have no deficiencies related to the allegations.
Inspection Report
Complaint Investigation
Census: 90
Deficiencies: 0
Dec 15, 2023
Visit Reason
This visit was for the Investigation of Complaint IN00422205.
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.
Complaint Details
Complaint IN00422205 - No deficiencies related to the allegations are cited.
Inspection Report
Complaint Investigation
Census: 101
Deficiencies: 1
Oct 19, 2023
Visit Reason
This visit was conducted for the investigation of complaints IN00418709 and IN00418732. Complaint IN00418709 resulted in state deficiencies related to the allegations, while Complaint IN00418732 had no deficiencies cited.
Findings
The facility failed to ensure that residents received shower assistance based on their preferences for 3 of 3 residents reviewed. Documentation and interviews revealed that showers were not consistently offered or completed according to the residents' preferred schedules, particularly on the 2nd shift.
Complaint Details
Complaint IN00418709 was substantiated with state deficiencies cited at R0240. Complaint IN00418732 had no deficiencies related to the allegations.
Deficiencies (1)
| Description |
|---|
| Failed to ensure residents received shower assistance based on their preferences for 3 of 3 residents reviewed (Resident B, Resident I, Resident J). |
Report Facts
Residential Census: 101
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Emiley Jewett | LPN, Director of Nursing (DON) | Provided shower schedule and interviewed regarding shower assistance deficiencies |
Inspection Report
Complaint Investigation
Census: 96
Deficiencies: 0
Sep 11, 2023
Visit Reason
This visit was for the investigation of Complaint IN00416172.
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.
Complaint Details
Investigation of Complaint IN00416172 found no deficiencies related to the allegations.
Inspection Report
Complaint Investigation
Census: 98
Deficiencies: 1
Aug 16, 2023
Visit Reason
This visit was conducted for the investigation of complaints IN00414047 and IN00414448. Complaint IN00414047 found no deficiencies, while complaint IN00414448 resulted in state deficiencies related to medication administration errors.
Findings
The facility failed to ensure residents' medications were administered as ordered, documented accurately, and residents were correctly identified to prevent medication errors for 3 residents (Resident B, Resident C, and Resident D). Multiple medication errors were documented, including overdosing Resident B with methotrexate, administering another resident's medication to Resident C, and duplicate medication administration to Resident D. The facility implemented corrective actions including audits, staff education, and policy reinforcement.
Complaint Details
Complaint IN00414047 - No deficiencies related to the allegations were cited. Complaint IN00414448 - State deficiencies related to medication administration errors were cited, including overdosing Resident B with methotrexate, administering wrong medications to Resident C, and duplicate medication administration to Resident D. The errors were reported to Nurse Practitioners and family members, with appropriate interventions and follow-up.
Deficiencies (1)
| Description |
|---|
| Failed to ensure residents' medications were administered as ordered, documented accurately, and accurate resident identification was implemented to prevent medication errors for 3 residents. |
Report Facts
Medication error incidents reported: 3
Resident B methotrexate dose: 2.5
Resident B methotrexate tablets: 10
Resident C medication error date: 2023
Resident D medication error date: 2023
Resident census: 98
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Renee Kreienbrink | Administrator | Signed the report as the facility administrator. |
Inspection Report
Complaint Investigation
Census: 96
Deficiencies: 0
Jul 24, 2023
Visit Reason
This visit was conducted for the investigation of complaints IN00413112, IN00413260, and IN00413410.
Findings
No deficiencies related to the allegations in any of the three complaints were cited. The facility was found to be in compliance with 410 IAC 16.2-5 regarding the investigation of these complaints.
Complaint Details
Complaints IN00413112, IN00413260, and IN00413410 were investigated and found to have no deficiencies related to the allegations.
Report Facts
Residential Census: 96
Inspection Report
Complaint Investigation
Census: 101
Deficiencies: 0
Jun 21, 2023
Visit Reason
This visit was for the Investigation of Complaint IN00410372.
Findings
No deficiencies related to the allegations are cited. Storypoint Fort Wayne West was found to be in compliance with 410 IAC 16.2-5 in regard to the Investigation of Complaint IN00410372.
Complaint Details
Complaint IN00410372 - No deficiencies related to the allegations are cited.
Inspection Report
Complaint Investigation
Census: 93
Deficiencies: 0
Apr 20, 2023
Visit Reason
This visit was for the Investigation of Complaint IN00405516.
Findings
No deficiencies related to the allegations were cited. Storypoint Fort Wayne West was found to be in compliance with 410 IAC 16.2-5 regarding the investigation.
Complaint Details
Complaint IN00405516 - No deficiencies related to the allegations are cited.
Inspection Report
Complaint Investigation
Census: 87
Deficiencies: 0
Feb 21, 2023
Visit Reason
This visit was conducted for the investigation of Complaint IN00401335.
Findings
The complaint was substantiated; however, no deficiencies related to the allegations were cited. The facility was found to be in compliance with applicable regulations.
Complaint Details
Complaint IN00401335 was substantiated but no deficiencies related to the allegations were cited.
Report Facts
Residential Census: 87
Inspection Report
Complaint Investigation
Census: 107
Deficiencies: 2
Sep 2, 2022
Visit Reason
This visit was conducted for the investigation of two substantiated complaints, IN00389052 and IN00389188, related to allegations of abuse and administrator licensure.
Findings
The facility failed to properly investigate an abuse allegation involving two residents and a CNA, and the Administrator did not have an active healthcare administrator license at the time of the survey. Corrective actions and staff education were planned and initiated.
Complaint Details
Complaint IN00389052 was substantiated with deficiencies related to failure to investigate abuse allegations. Complaint IN00389188 was substantiated with deficiencies related to Administrator licensure.
Deficiencies (2)
| Description |
|---|
| Failed to investigate an abuse allegation for 2 of 4 residents reviewed. |
| Failed to ensure the Administrator had an active healthcare administrator license. |
Report Facts
Residential Census: 107
Deficiencies cited: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Director of Nursing | Director of Nursing | Provided incident report and interviews regarding abuse allegations. |
| Administrator | Administrator | Indicated not having an active healthcare administrator license. |
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