Inspection Reports for Summit Place West
55 Mission Dr, Indianapolis, IN 46214, IN, 46214
Back to Facility ProfileInspection Report Summary
The most recent inspection on April 11, 2025, identified deficiencies related to medication administration, labeling, disposal, confidentiality, and infection control. Earlier inspections showed a pattern of issues involving medication management and infection control, as well as care planning for residents with mental illness and food safety practices. Complaint investigations were mostly unsubstantiated except for the substantiated complaint in April 2025 regarding medication and infection control deficiencies. No fines, immediate jeopardy findings, or enforcement actions were listed in the available reports. The facility’s inspection history shows recurring challenges in medication and infection control areas without a clear trend of improvement or worsening.
Deficiencies (last 4 years)
Deficiencies (over 4 years)
4 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
5% better than Indiana average
Indiana average: 4.2 deficiencies/yearDeficiencies per year
8
6
4
2
0
Census
Latest occupancy rate
42 residents
Based on a April 2025 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Census over time
Inspection Report
Complaint Investigation
Census: 42
Deficiencies: 6
Date: Apr 11, 2025
Visit Reason
This visit was conducted for the investigation of Complaint IN00455250 regarding multiple state deficiencies related to medication administration, labeling, disposal, confidentiality, and infection control.
Complaint Details
Complaint IN00455250 was substantiated with multiple state deficiencies cited related to medication administration, labeling, disposal, confidentiality, and infection control.
Findings
The facility was found deficient in multiple areas including failure to provide ongoing training to medication staff, improper labeling and dating of medications, unsecured medication carts, improper disposal of unadministered medications, failure to maintain resident confidentiality, and inadequate infection control practices during medication administration.
Deficiencies (6)
Failed to provide ongoing training to ensure competency of medication staff.
Failed to ensure over the counter and prescription medications were properly labeled and dated.
Failed to ensure medication cart was locked and medications secured while unattended.
Failed to ensure unadministered medications were properly disposed of.
Failed to ensure resident confidential information was properly concealed while MAR book was left unattended.
Failed to ensure residents had a sanitary environment; improper hand hygiene and glucometer cleaning during medication pass.
Report Facts
Residents affected: 42
Residents observed for medication disposal: 5
Medication cart unattended lock failures: 7
Medication pass observations frequency: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| QMA 3 | Qualified Medication Aide | Named in multiple findings including improper medication handling, failure to lock medication cart, improper disposal of medications, and infection control violations. |
| QMA 4 | Qualified Medication Aide | Involved in medication pass observations and medication disposal practices. |
| Brittany McKinney | HFA | Laboratory Director or Provider/Supplier Representative who signed the report. |
Inspection Report
Complaint Investigation
Census: 40
Deficiencies: 1
Date: Sep 5, 2024
Visit Reason
This visit was conducted for the investigation of four complaints (IN00442289, IN00441075, IN00441073, and IN00441071) regarding the facility.
Complaint Details
Complaint IN00442289 - No deficiencies related to the allegations are cited. Complaint IN00441075 - State deficiencies related to the allegations are cited at R0383. Complaint IN00441073 - No deficiencies related to the allegations are cited. Complaint IN00441071 - No deficiencies related to the allegations are cited.
Findings
The facility was found deficient for failing to ensure residents with major mental illness diagnoses had person-centered comprehensive care plans developed and implemented in collaboration with their mental health providers for 3 of 3 residents reviewed. No deficiencies were cited for three of the complaints, with deficiencies related only to complaint IN00441075.
Deficiencies (1)
Failed to ensure residents with diagnoses of major mental illness had person-centered comprehensive care plans initiated and implemented in corroboration with their mental health provider for 3 of 3 residents reviewed.
Report Facts
Residential Census: 40
Number of residents reviewed for major mental illness: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Brittany McKinney | Regulatory Consultant | Interviewed and provided findings regarding lack of comprehensive care plans for residents with major mental illness |
Inspection Report
Census: 34
Deficiencies: 6
Date: May 24, 2024
Visit Reason
This visit was for a State Residential Licensure Survey conducted on May 28, 29, and 30, 2024.
Findings
The facility was found deficient in multiple areas including food labeling and temperature monitoring in the kitchen, medication security for residents who self-medicate, timely response to pharmacy recommendations, proper medication labeling and disposal, and infection control practices such as disinfecting blood glucometers.
Deficiencies (6)
Failed to ensure all food was labeled and dated and thermometers were used to measure internal temperatures in refrigerators and freezers.
Failed to ensure medications were secure for residents who self-medicate, with medications visible and unsecured.
Failed to respond to pharmacy recommendations in a timely manner for residents reviewed.
Failed to date eye drops and remove expired medications from medication cart.
Failed to complete drug disposal log for residents discharged from the facility.
Failed to disinfect blood glucometer after use for a resident.
Report Facts
Survey dates: 3
Residents observed for medication security: 3
Residents reviewed for pharmacy recommendations: 8
Residents reviewed for medication storage: 15
Residents reviewed for drug disposal log: 2
Blood sugar reading: 188
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Alicia Harris | Administrator | Provided policies and interviewed regarding facility practices |
| Dietary Manager | Observed during kitchen inspection and interviewed about food labeling | |
| Director of Nursing | Responsible for monitoring medication security and pharmacy recommendations | |
| Licensed Practical Nurse 3 | Interviewed regarding medication reconciliation and glucometer disinfection | |
| Qualified Medication Aide 4 | Observed during medication cart inspection and blood sugar testing |
Inspection Report
Complaint Investigation
Census: 39
Deficiencies: 0
Date: Sep 5, 2023
Visit Reason
This visit was conducted for the investigation of Complaint IN00411143.
Complaint Details
Complaint IN00411143 was investigated and found to have no deficiencies related to the allegations.
Findings
No deficiencies related to the allegations were cited, and the facility was found to be in compliance with 410 IAC 16.2-5 regarding the complaint investigation.
Inspection Report
Census: 34
Deficiencies: 3
Date: Dec 9, 2022
Visit Reason
This visit was for a State Residential Licensure Survey to assess compliance with state regulations for the facility.
Findings
The facility was found deficient in allowing residents to have pets as per policy and admission agreement, failure of the kitchen manager to wear a beard cover in the kitchen prep area, and failure to follow CDC guidance for COVID-19 infection control practices including PPE use and signage for a COVID-positive resident's apartment.
Deficiencies (3)
Facility failed to allow residents to have the choice of a pet and did not inform residents in the admission agreement that pets were not allowed to reside in the facility.
Kitchen manager failed to wear a beard cover in the kitchen prep area.
Facility failed to follow CDC guidance for COVID-19 infection control practices for PPE use and signage for a COVID-positive resident.
Report Facts
Residents affected: 34
Residents affected: 34
Residents affected: 34
Residents reviewed for infection control: 3
Residents reviewed for infection control: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Alicia Harris | Administrator | Provided pet policy and admission agreement information |
| Director of Nursing | Interviewed regarding pet policy enforcement and infection control practices | |
| Kitchen Manager | Observed not wearing beard cover in kitchen prep area | |
| Home Health Aid | Observed PPE use during resident transport and interviewed about infection control |
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