Inspection Reports for Vermillion Convalescent Center
1705 S Main St, Clinton, IN 47842, IN, 47842
Back to Facility ProfileDeficiencies per Year
8
6
4
2
0
Moderate
Low
Census Over Time
Census
Capacity
Inspection Report
Complaint Investigation
Census: 72
Capacity: 72
Deficiencies: 0
Jun 30, 2025
Visit Reason
This visit was conducted for the investigation of complaints IN00458839 and IN00460476.
Findings
No deficiencies related to the allegations in complaints IN00458839 and IN00460476 were cited. The facility was found to be in compliance with applicable regulations.
Complaint Details
Complaint IN00458839 - No deficiencies related to the allegations are cited. Complaint IN00460476 - No deficiencies related to the allegations are cited.
Report Facts
Census: 72
Total Capacity: 72
Medicare Census: 6
Medicaid Census: 57
Other Payor Census: 9
Inspection Report
Complaint Investigation
Census: 79
Capacity: 79
Deficiencies: 0
Mar 19, 2025
Visit Reason
This visit was conducted for the investigation of Complaint IN00453248.
Findings
No deficiencies related to the complaint allegations were cited. The facility was found to be in compliance with applicable regulations.
Complaint Details
Complaint IN00453248 was investigated and found to have no deficiencies related to the allegations.
Report Facts
Medicare residents: 9
Medicaid residents: 56
Other residents: 14
Inspection Report
Complaint Investigation
Census: 74
Capacity: 74
Deficiencies: 0
Jan 3, 2025
Visit Reason
This visit was conducted for the investigation of Complaint IN00446308.
Findings
No deficiencies related to the complaint allegations were cited. The facility was found to be in compliance with relevant regulations.
Complaint Details
Complaint IN00446308 was investigated and found to have no deficiencies related to the allegations.
Report Facts
Medicare residents: 9
Medicaid residents: 50
Other residents: 15
Inspection Report
Re-Inspection
Census: 76
Capacity: 119
Deficiencies: 0
Sep 12, 2024
Visit Reason
A Post Survey Revisit (PSR) to the Life Safety Code Recertification and State Licensure Survey conducted on 08/08/24 was performed to verify compliance with previous findings.
Findings
At this PSR survey, Vermillion Convalescent Center was found in compliance with Medicare/Medicaid participation requirements, Life Safety from Fire, and the 2012 edition of the NFPA 101 Life Safety Code, Chapter 19, Existing Health Care Occupancies and 410 IAC 16.2.
Report Facts
Facility capacity: 119
Census: 76
Inspection Report
Renewal
Deficiencies: 0
Aug 21, 2024
Visit Reason
Paper compliance review to the Recertification and State Licensure survey conducted on July 22, 2024.
Findings
Vermillion Convalescent 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 Recertification and State Licensure.
Inspection Report
Life Safety
Census: 79
Capacity: 100
Deficiencies: 5
Aug 8, 2024
Visit Reason
The survey 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, including issues with hazardous area door closures, corridor door impediments, smoke barrier door malfunctions, lack of GFCI protection in restrooms, and improper storage of liquid oxygen containers in resident rooms.
Severity Breakdown
E: 3
D: 1
A: 1
Deficiencies (5)
| Description | Severity |
|---|---|
| Failed to ensure hazardous area storage room door was self-closing and latched properly. | E |
| One corridor door had an impediment to closing and latching, requiring considerable force. | D |
| One set of smoke barrier doors failed to close tightly, leaving a 4-inch gap. | E |
| Restrooms were not provided with functioning ground fault circuit interrupter (GFCI) protection. | E |
| Liquid oxygen containers were stored in resident rooms not separated by fire barriers with required fire resistance rating and self-closing doors. | A |
Report Facts
Certified beds: 100
Census: 79
Residents potentially affected by hazardous area door deficiency: 10
Residents potentially affected by smoke barrier door deficiency: 20
Residents potentially affected by GFCI deficiency: 5
Residents potentially affected by liquid oxygen storage deficiency: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Melissa Gum | RN, HFA/Administrator | Signed the report |
| Maintenance Director | Interviewed and confirmed deficiencies related to door closures, GFCI receptacle, and liquid oxygen storage | |
| Assistant Administrator | Present at exit conference and reviewed findings |
Inspection Report
Annual Inspection
Census: 76
Capacity: 76
Deficiencies: 5
Jul 22, 2024
Visit Reason
This visit was for a Recertification and State Licensure Survey conducted from July 16 to July 22, 2024.
Findings
The facility was found deficient in several areas including failure to maintain resident dignity during transport, incomplete documentation of resident hospital transfers, improper catheter bag placement, improper medication labeling and storage, and incomplete medication administration documentation.
Severity Breakdown
SS=D: 5
Deficiencies (5)
| Description | Severity |
|---|---|
| Failure to aid a resident in a manner that maintained or enhanced their dignity during transport in a shower chair. | SS=D |
| Failure to ensure documentation of a resident's transfer included physician and family notification. | SS=D |
| Failure to ensure a resident's indwelling urinary catheter bag and tubing were kept from making contact with the floor. | SS=D |
| Failure to ensure medications were labeled and stored properly in medication and treatment carts. | SS=D |
| Failure to ensure medications administered to a resident had been documented. | SS=D |
Report Facts
Survey dates: 5
Census: 76
Total capacity: 76
Medicare residents: 11
Medicaid residents: 52
Other payor residents: 13
Deficiency completion dates: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Melissa Gum | RN, HFA/Administrator | Signed the report as provider/supplier representative |
| Licensed Practical Nurse 4 | Licensed Practical Nurse | Interviewed regarding resident dignity and medication labeling |
| Student Nurse Aide 4 | Student Nurse Aide | Interviewed regarding resident dignity during transport |
| Licensed Practical Nurse 13 | Licensed Practical Nurse | Interviewed regarding hospital transfer documentation |
| Regional Nurse Consultant | Regional Nurse Consultant | Provided policies and interviewed regarding multiple deficiencies |
| Assistant Director of Nursing | Assistant Director of Nursing | Interviewed regarding medication storage and catheter bag placement |
Inspection Report
Complaint Investigation
Census: 71
Capacity: 71
Deficiencies: 1
Nov 6, 2023
Visit Reason
This visit was conducted for the investigation of complaint IN00420470 regarding allegations of improper use of physical restraints at the facility.
Findings
The facility failed to ensure that residents' self-releasing seat belts were secured in a manner that allowed residents to freely release them for 2 of 4 residents reviewed. The issue involved a Certified Nursing Aide who used tape to secure the belts, preventing self-release. The facility conducted a full investigation, re-educated staff, terminated the responsible CNA, and corrected the deficient practice prior to the survey.
Complaint Details
Complaint IN00420470 was substantiated with federal/state deficiencies cited related to the allegations of improper restraint use involving tape applied to self-releasing seat belts by a CNA. The CNA was suspended, re-educated, and ultimately terminated following investigation.
Severity Breakdown
SS=D: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Facility failed to ensure residents' self-releasing seat belts were secured to allow free release for 2 of 4 residents reviewed. | SS=D |
Report Facts
Census: 71
Total Capacity: 71
Medicare Census: 6
Medicaid Census: 51
Other Payor Census: 14
PHQ-9 Score Resident B: 6
PHQ-9 Score Resident C: 11
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| CNA 8 | Certified Nursing Aide | Named in finding for taping residents' self-releasing seat belts, resulting in termination |
| Assistant Director of Nursing | ADON | Re-educated CNA 8 and involved in investigation |
| Administrator | ADM | Provided internal investigation documentation and oversaw investigation |
| Former Director of Nursing | DON | Provided statements and education related to the incident |
| Laundry Aide 11 | Laundry Aide | Observed tape on seat belts and reported to staff |
Inspection Report
Re-Inspection
Census: 71
Capacity: 119
Deficiencies: 0
Aug 15, 2023
Visit Reason
A Post-Survey Revisit (PSR) to the Life Safety Code Recertification and State Licensure Survey conducted on 07/11/23 was performed to verify compliance with previous deficiencies.
Findings
At this PSR survey, Vermillion Convalescent Center was found in compliance with Medicare/Medicaid participation requirements, Life Safety from Fire, and the 2012 edition of the NFPA 101 Life Safety Code. The facility was fully sprinklered with appropriate fire alarm and smoke detection systems.
Report Facts
Facility capacity: 119
Census: 71
Inspection Report
Renewal
Deficiencies: 0
Aug 1, 2023
Visit Reason
The inspection was a paper compliance review related to the Recertification and State Licensure survey completed on June 15, 2023.
Findings
Vermillion Convalescent 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 Recertification and State Licensure.
Inspection Report
Life Safety
Census: 72
Capacity: 119
Deficiencies: 4
Jul 11, 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 on 07/11/2023.
Findings
The facility was found in compliance with Emergency Preparedness Requirements but not in compliance with Life Safety Code requirements. Deficiencies included failure to test battery backup emergency lights monthly, corroded and dirty sprinkler heads in the kitchen, a corridor door that was difficult to close and latch, and failure to test non-hospital grade electrical receptacles in resident sleeping rooms annually.
Severity Breakdown
SS=F: 2
SS=E: 1
SS=D: 1
Deficiencies (4)
| Description | Severity |
|---|---|
| Failed to ensure 1 of 1 battery backup lights were tested monthly as required. | SS=F |
| Failed to ensure all sprinkler heads in the kitchen were free of corrosion, dirt, grease, and foreign material. | SS=E |
| One corridor door to Resident Room 251 had an impediment to closing and latching, requiring considerable force to operate. | SS=D |
| Failed to ensure non-hospital grade electrical receptacles at 55 resident sleeping rooms were tested at least annually. | SS=F |
Report Facts
Certified beds: 119
Census: 72
Non-hospital grade electrical receptacles: 55
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Melissa Gum | Administrator | Named during exit conference and signature on report |
| Maintenance Director | Interviewed regarding deficiencies and testing records | |
| Maintenance Supervisor | Responsible for corrective actions and testing |
Inspection Report
Annual Inspection
Census: 68
Capacity: 68
Deficiencies: 4
Jun 15, 2023
Visit Reason
This visit was for a Recertification and State Licensure Survey, which included the Investigation of Complaint IN00405579.
Findings
The facility was found deficient in several areas including failure to ensure code status/advance directive documents matched physician orders, food temperature and palatability issues, unsanitary kitchen conditions, improper food handling by staff, and employment of a licensed nurse with an expired license. Corrective actions and monitoring plans were implemented for each deficiency.
Complaint Details
Complaint IN00405579 was investigated and no deficiencies related to the allegations were cited.
Severity Breakdown
SS=D: 4
Deficiencies (4)
| Description | Severity |
|---|---|
| Failed to ensure the Code Status/Advanced Directive document matched the physician's order for code status for 1 of 24 residents reviewed. | SS=D |
| Failed to ensure the temperature and palatability of food served for 1 of 1 test tray and 2 of 26 residents reviewed for food palatability. | SS=D |
| Failed to ensure cleanliness and sanitation of the kitchen and food preparation/storage areas and sanitary food handling when assisting residents with eating. | SS=D |
| Failed to ensure that all licensed employees had an active Indiana license for 1 of 69 licensed employees. | SS=D |
Report Facts
Census: 68
Total Capacity: 68
Medicare Census: 7
Medicaid Census: 52
Other Payor Census: 9
Expired License Date: Oct 31, 2022
Food Temperature: 100
Food Temperature: 135
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Melissa Gum | Administrator | Signed the report and plan of correction |
| LPN 15 | Licensed Practical Nurse | Had an expired Indiana nursing license and was removed from schedule |
| Licensed Practical Nurse 10 | Licensed Practical Nurse | Interviewed regarding code status document at nurse's station |
| Director of Nursing | Director of Nursing | Interviewed regarding code status document and facility policies |
| Dietary Manager | Dietary Manager | Interviewed regarding food temperature and kitchen sanitation |
| Dietary Aide 17 | Dietary Aide | Observed entering kitchen without hairnet and placing personal items on kitchen cart |
| Certified Nursing Aide 7 | Certified Nursing Aide | Observed handling resident food without hand sanitation |
| Regional Nurse Consultant | Regional Nurse Consultant | Interviewed regarding expired license and facility policies |
| Regional Manager | Regional Manager | Provided job description policy |
Inspection Report
Complaint Investigation
Census: 72
Capacity: 72
Deficiencies: 0
Nov 18, 2022
Visit Reason
This visit was conducted for the investigation of Complaint IN00388531.
Findings
The complaint IN00388531 was found to be unsubstantiated due to lack of evidence. The facility was found to be in compliance with relevant regulations.
Complaint Details
Complaint IN00388531 was investigated and determined to be unsubstantiated due to lack of evidence.
Report Facts
Census: 72
Total Capacity: 72
Medicare Residents: 9
Medicaid Residents: 54
Other Payor Residents: 9
Inspection Report
Renewal
Deficiencies: 0
Sep 30, 2022
Visit Reason
The inspection was conducted as a paper compliance review related to the Recertification and State Licensure survey.
Findings
The Vermillion Convalescent 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 Recertification and State Licensure.
Inspection Report
Life Safety
Census: 63
Capacity: 119
Deficiencies: 5
Jul 27, 2022
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 Life Safety Code requirements, including failure to maintain spare sprinklers, inadequate inspection of portable fire extinguishers, malfunctioning smoke barrier doors, and insufficient intake combustion air in the boiler room. Corrective actions were planned and documented.
Severity Breakdown
SS=F: 2
SS=D: 2
SS=E: 1
Deficiencies (5)
| Description | Severity |
|---|---|
| Failed to ensure spare sprinklers, a sprinkler cabinet, and a sprinkler wrench were maintained on the premises as required by NFPA 25. | SS=F |
| Failed to ensure all loaded sprinklers were replaced or cleaned in accordance with NFPA 25. | SS=F |
| Failed to ensure 1 of 23 portable fire extinguishers was inspected at least monthly and documented accordingly. | SS=D |
| Failed to ensure 1 of 6 sets of smoke barrier doors would restrict the movement of smoke for at least 20 minutes due to malfunctioning door closing coordinator. | SS=E |
| Failed to ensure 1 of 1 boiler rooms were provided with intake combustion air from the outside for rooms containing fuel fired equipment. | SS=D |
Report Facts
Certified beds: 119
Census: 63
Portable fire extinguishers: 23
Sets of smoke barrier doors: 6
Boiler rooms: 1
Inspection Report
Life Safety
Deficiencies: 0
Jul 27, 2022
Visit Reason
Paper compliance to the Life Safety Code Recertification and State Licensure Survey conducted on 07/27/22 was completed on 08/18/22.
Findings
Vermillion Convalescent 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.
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