Inspection Report
Complaint Investigation
Census: 126
Deficiencies: 0
Jun 12, 2025
Visit Reason
This visit was conducted for the investigation of Complaint IN00460775.
Findings
No deficiencies related to the complaint allegations were cited; the facility was found to be in compliance with applicable regulations.
Complaint Details
Complaint IN00460775 was investigated and found to have no deficiencies related to the allegations.
Report Facts
Census Bed Type Total: 126
Census Payor Type Total: 126
Census SNF/NF: 56
Census SNF: 14
Census Residential: 56
Census Medicare: 3
Census Medicaid: 21
Census Other Payor: 102
Inspection Report
Re-Inspection
Census: 82
Capacity: 128
Deficiencies: 0
Feb 13, 2025
Visit Reason
A Post Survey Revisit (PSR) to the Life Safety Code Recertification and State Licensure Survey conducted on 01/07/25 by the Indiana Department of Health.
Findings
Swiss Village 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, Chapter 19, Existing Health Care Occupancies and 410 IAC 16.2. The facility is fully sprinklered with a fire alarm system and smoke detection in required areas.
Report Facts
Facility capacity: 128
Census: 82
Inspection Report
Life Safety
Census: 73
Capacity: 128
Deficiencies: 7
Jan 7, 2025
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.
Findings
The facility was found in compliance with Emergency Preparedness Requirements but not in compliance with Life Safety Code requirements. Multiple deficiencies were identified related to fire barrier penetrations, fire resistance ratings of separation walls, exit signage illumination, sprinkler system maintenance, smoke barrier penetrations, and incomplete fire safety plans.
Severity Breakdown
SS=E: 5
SS=F: 1
SS=C: 1
Deficiencies (7)
| Description | Severity |
|---|---|
| Penetrations in 2 of 2 fire barrier walls were not maintained to ensure two-hour fire resistance. | SS=E |
| One of two sets of separation fire barrier walls was constructed with less than the required two-hour fire resistance rating. | SS=E |
| Failed to maintain building type II(111) by ensuring fire separation barrier assemblies were maintained with two-hour fire resistance and constructed of enclosed noncombustible material. | SS=E |
| One of two stairway exits lacked exit signs with continuous illumination. | SS=E |
| Failed to maintain 2 of 2 sprinkler systems in accordance with NFPA 25; spare sprinkler heads expired and fire department connections damaged. | SS=F |
| Penetrations caused by passage of wire/conduit through 2 of 9 smoke barrier walls were not protected to maintain smoke resistance. | SS=E |
| Failed to provide a written fire safety plan addressing all required components including identification of smoke barrier doors. | SS=C |
Report Facts
Residents affected: 40
Residents affected: 25
Residents affected: 30
Residents affected: 30
Residents affected: 40
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sierra Saylor | VP of Operations | Signed report and participated in exit conference |
| Maintenance Director | Interviewed regarding fire barrier penetrations, fire wall construction, exit signage, sprinkler system, smoke barrier penetrations, and fire safety plan | |
| Administrator | Participated in exit conference and reviewed findings |
Inspection Report
Renewal
Census: 244
Deficiencies: 0
Dec 10, 2024
Visit Reason
This visit was for a Recertification and State Licensure Survey, including a State Residential Licensure Survey conducted on December 4, 5, 6, 9, and 10, 2024.
Findings
Swiss Village was found to be in compliance with 42 CFR Part 483, Subpart B and 410 IAC 16.2-3.1 in regard to the Recertification and State Licensure Survey.
Report Facts
Census: 244
Census Bed Type: 244
Census Payor Type: 244
Inspection Report
Complaint Investigation
Census: 79
Deficiencies: 0
Sep 26, 2024
Visit Reason
This visit was conducted to investigate complaints IN00442194, IN00443649, and IN00443952 at the facility.
Findings
No deficiencies related to the allegations in complaints IN00442194, IN00443649, and IN00443952 were cited. The facility was found to be in compliance with applicable regulations.
Complaint Details
Complaints IN00442194, IN00443649, and IN00443952 were investigated and found to have no deficiencies related to the allegations.
Report Facts
Census: 79
SNF Beds: 16
SNF/NF Beds: 63
Medicare Residents: 3
Medicaid Residents: 33
Other Residents: 13
Inspection Report
Complaint Investigation
Census: 136
Deficiencies: 0
Aug 7, 2024
Visit Reason
This visit was for the Investigation of Complaint IN00439716.
Findings
No deficiencies related to the allegations were cited. The facility was found to be in compliance with 42 CFR Part 483, Subpart B and 410 IAC 16.2-3.1 regarding the complaint investigation.
Complaint Details
Complaint IN00439716 was investigated and found to have no deficiencies related to the allegations.
Report Facts
Census Bed Type - SNF/NF: 67
Census Bed Type - SNF: 17
Census Bed Type - Residential: 52
Census Total: 136
Census Payor Type - Medicare: 4
Census Payor Type - Medicaid: 36
Census Payor Type - Other: 96
Inspection Report
Complaint Investigation
Census: 135
Deficiencies: 0
Jul 23, 2024
Visit Reason
This visit was conducted for the investigation of complaints IN00436741 and IN00439118.
Findings
No deficiencies related to the allegations in complaints IN00436741 and IN00439118 were cited. The facility was found to be in compliance with relevant regulations.
Complaint Details
Investigation of Complaints IN00436741 and IN00439118 found no deficiencies related to the allegations.
Report Facts
Census Bed Type - SNF/NF: 67
Census Bed Type - SNF: 16
Census Bed Type - Residential: 52
Census Total: 135
Census Payor Type - Medicare: 3
Census Payor Type - Medicaid: 36
Census Payor Type - Other: 96
Inspection Report
Complaint Investigation
Census: 83
Capacity: 136
Deficiencies: 0
Jun 5, 2024
Visit Reason
This visit was conducted for the investigation of Complaint IN00434272.
Findings
No deficiencies related to the allegations in Complaint IN00434272 were cited. The facility was found to be in compliance with applicable regulations.
Complaint Details
Complaint IN00434272 was investigated and found to have no deficiencies related to the allegations.
Report Facts
Census Bed Type - SNF/NF: 65
Census Bed Type - SNF: 18
Census Bed Type - Residential: 53
Total Capacity: 136
Census Payor Type - Medicare: 6
Census Payor Type - Medicaid: 41
Census Payor Type - Other: 36
Current Census: 83
Inspection Report
Re-Inspection
Census: 82
Capacity: 128
Deficiencies: 0
May 16, 2024
Visit Reason
A Post Survey Revisit (PSR) was conducted to the Emergency Preparedness Survey and the Life Safety Code Recertification and State Licensure Survey originally conducted on 02/20/24.
Findings
At this PSR survey, Swiss Village was found in compliance with Emergency Preparedness Requirements and Life Safety Code requirements including fire safety and sprinkler systems. The facility was fully sprinklered with a fire alarm system and smoke detection in required areas.
Inspection Report
Complaint Investigation
Census: 86
Capacity: 138
Deficiencies: 0
Apr 15, 2024
Visit Reason
This visit was conducted for the investigation of Nursing Home Complaint IN00429928 and included the investigation of Residential Complaint IN00430850.
Findings
No deficiencies related to the allegations in complaint IN00429928 were cited. The facility was found to be in compliance with applicable regulations.
Complaint Details
Complaint IN00429928 was investigated and found to have no deficiencies related to the allegations.
Report Facts
Census Bed Type - SNF/NF: 62
Census Bed Type - SNF: 24
Census Bed Type - Residential: 52
Total Capacity: 138
Census Payor Type - Medicare: 6
Census Payor Type - Medicaid: 40
Census Payor Type - Other: 40
Current Census: 86
Inspection Report
Life Safety
Census: 82
Capacity: 128
Deficiencies: 8
Feb 20, 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 federal regulations and state codes.
Findings
The facility was found not in compliance with Emergency Preparedness Requirements and Life Safety Code requirements including emergency power system maintenance, egress door locking, sprinkler system maintenance, corridor door latching, ground fault circuit interrupter maintenance, fire drill scheduling, essential electrical system testing, and improper use of extension cords.
Severity Breakdown
SS=F: 4
SS=E: 2
SS=D: 2
Deficiencies (8)
| Description | Severity |
|---|---|
| Failed to implement emergency power system requirements; generator annual fuel quality testing failed due to contamination. | SS=F |
| Failed to ensure egress door was not equipped with a latch or lock requiring a tool or key from the egress side; exit door at Assisted Dining Room was magnetically locked without posted code. | SS=E |
| Failed to maintain 2 of 2 sprinkler systems with complete inspection documentation; missing date on internal inspection of piping. | SS=F |
| Failed to ensure corridor door to resident room 386 would close and latch properly to resist passage of smoke. | SS=D |
| Failed to ensure 1 of over 20 ground fault circuit interrupters (GFCI) was properly maintained; reset button broken on receptacle near sink in Assisted Dining Room. | SS=D |
| Failed to conduct fire drills on each shift for 1 of 4 quarters in 2023. | SS=F |
| Failed to ensure emergency power system testing and maintenance per NFPA 110; generator fuel quality test failed. | SS=F |
| Failed to ensure flexible cords were not used as substitute for fixed wiring; extension cords used in resident rooms and other areas. | SS=E |
Report Facts
Facility capacity: 128
Census: 82
Deficiency count: 8
Fire drills missing: 1
Systemic correction completion date: May 10, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sierra Saylor | VP of Operations | Named as facility representative signing the report and involved in exit conferences. |
| Director of Facilities | Involved in interviews and corrective action discussions related to deficiencies. | |
| Administrator | Involved in interviews and exit conferences related to deficiencies. |
Inspection Report
Renewal
Census: 134
Deficiencies: 0
Feb 7, 2024
Visit Reason
This visit was for a Recertification and State Licensure Survey, including a State Residential Licensure Survey conducted over multiple days in February 2024.
Findings
Swiss Village was found to be in compliance with 42 CFR Part 483, Subpart B and 410 IAC 16.2-3.1 in regard to the Recertification and State Licensure Survey.
Report Facts
Census: 134
Census Bed Type: 58
Census Bed Type: 20
Census Bed Type: 56
Census Payor Type: 4
Census Payor Type: 38
Census Payor Type: 92
Inspection Report
Complaint Investigation
Census: 82
Capacity: 140
Deficiencies: 0
Dec 18, 2023
Visit Reason
The visit was conducted for the investigation of Nursing Home Complaint IN00422736 and Residential Complaint IN00423958, as well as a Residential COVID-19 Quality Assurance Walk Through.
Findings
No deficiencies related to the allegations in either complaint were cited. The facility was found to be in compliance with relevant federal and state regulations regarding the complaints and the COVID-19 Quality Assurance Walk Through.
Complaint Details
Complaint IN00422736 and Complaint IN00423958 were investigated with no deficiencies related to the allegations cited.
Report Facts
Census Bed Type - SNF/NF: 60
Census Bed Type - SNF: 22
Census Bed Type - Residential: 58
Total Capacity: 140
Census Payor Type - Medicare: 5
Census Payor Type - Medicaid: 42
Census Payor Type - Other: 35
Total Census: 82
Inspection Report
Complaint Investigation
Census: 83
Capacity: 83
Deficiencies: 0
Oct 19, 2023
Visit Reason
This visit was conducted for the investigation of Complaint IN00418369.
Findings
No deficiencies related to the complaint allegations were cited. The facility was found to be in compliance with applicable regulations.
Complaint Details
Investigation of Complaint IN00418369 found no deficiencies related to the allegations; the complaint was not substantiated.
Report Facts
Census Payor Type - Medicare: 5
Census Payor Type - Medicaid: 43
Census Payor Type - Other: 35
Inspection Report
Life Safety
Census: 87
Capacity: 128
Deficiencies: 0
Apr 24, 2023
Visit Reason
A Post Survey Revisit (PSR) to the Life Safety Code Recertification and State Licensure Survey conducted on 03/02/23 was performed by the Indiana Department of Health in accordance with 42 CFR Subpart 483.90(a).
Findings
At this Life Safety Code Survey, Swiss Village was found in compliance with the Requirements for Medicare and Medicaid Participating Providers and Suppliers, 42 CFR 483.90(a).
Inspection Report
Annual Inspection
Deficiencies: 0
Mar 21, 2023
Visit Reason
The inspection was conducted as a paper compliance review for the Annual Recertification and State Licensure survey.
Findings
Swiss Village 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.
Inspection Report
Life Safety
Census: 84
Capacity: 128
Deficiencies: 2
Mar 2, 2023
Visit Reason
The visit was conducted as a Life Safety Code Recertification and State Licensure Survey by the Indiana Department of Health in accordance with 42 CFR 483.90(a).
Findings
The facility was found not in compliance with Life Safety Code requirements, specifically failing to maintain the fire alarm system with required semi-annual visual inspections and failing to perform an annual fuel quality test for diesel generators. Corrective actions and systemic changes were planned to address these deficiencies.
Severity Breakdown
SS=F: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Failed to maintain 1 of 1 fire alarm systems in accordance with NFPA 72, lacking documentation of a required semi-annual visual inspection. | SS=F |
| Failed to ensure an annual fuel quality test was performed for 2 of 2 facility diesel powered generators as required by NFPA 110. | SS=F |
Report Facts
Facility capacity: 128
Census: 84
Deficiencies cited: 2
Plan of correction completion date: Apr 21, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sierra Saylor | VP of Operations | Named in relation to review of findings and exit conference |
Inspection Report
Annual Inspection
Census: 50
Capacity: 135
Deficiencies: 3
Feb 14, 2023
Visit Reason
This visit was for a Recertification and State Licensure Survey, including a State Residential Licensure Survey conducted from February 7 to 14, 2023.
Findings
The facility was found to have deficiencies related to pressure ulcer care and documentation, fall prevention interventions, and monitoring of psychotropic medication side effects. Corrective actions and education plans were outlined, with systemic changes to be completed by March 20, 2023. The facility was found in compliance with state residential licensure requirements.
Severity Breakdown
SS=D: 2
SS=E: 1
Deficiencies (3)
| Description | Severity |
|---|---|
| Failed to ensure a pressure ulcer was accurately assessed and documented for 1 of 2 residents reviewed (Resident 31). | SS=D |
| Failed to provide fall prevention interventions for 1 of 3 residents reviewed (Resident 52). | SS=D |
| Failed to ensure side effect monitoring was completed for 4 of 6 residents reviewed (Residents 31, 52, 72, and 73) on psychotropic medications. | SS=E |
Report Facts
Survey dates: 6
Census Bed Type Total Capacity: 135
Current Census: 50
Resident 52 falls: 28
Completion date for corrective actions: 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Sierra M Saylor | VP of Operations | Signed the report |
| LPN 6 | Licensed Practical Nurse, wound nurse | Observed dressing change and wound assessment for Resident 31 |
| QMA 2 | Qualified Medication Assistant | Provided information regarding Resident 52's fall risk and medication side effect monitoring |
| QMA 4 | Qualified Medication Assistant | Provided information about CNA staffing and resident supervision |
| Assistant Director of Nursing | ADON | Provided interview information about wound measurement program and monitoring |
Inspection Report
Complaint Investigation
Census: 144
Deficiencies: 0
Jan 10, 2023
Visit Reason
This visit was conducted for the investigation of Complaint IN00398240.
Findings
The complaint was substantiated; however, no deficiencies related to the allegations were cited. The facility was found to be in compliance with relevant regulations.
Complaint Details
Complaint IN00398240 was substantiated but no deficiencies related to the allegations were cited.
Report Facts
Census Bed Type - SNF/NF: 66
Census Bed Type - SNF: 28
Census Bed Type - Residential: 50
Census Bed Type - Total: 144
Census Payor Type - Medicare: 10
Census Payor Type - Medicaid: 36
Census Payor Type - Other: 98
Census Payor Type - Total: 144
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