Indiana State Department of Health

Division of Long Term Care

CONSUMER REPORT

CEDAR CREEK OF SEYMOUR

NURSING HOME

RESIDENTIAL FACILITY

Created on: 10/4/2024

Posted to the Web on: 10/16/2024
Basic Information
FACILITY CONTACT INFORMATION: Address: 2288 NICHOLAS CT City: SEYMOUR Telephone: (812) 523-8991 Web Site: NAME CHANGES: Most recent name change: SEYMOUR PLACE Date of most recent name change: 8/9/2023 3:01:11 PM LICENSE INFORMATION: License number: 24-004376-1 License effective date: 1/10/2024 License expiration date: 12/31/2024
Administration and Staff
Administrator: Start date: N/A Director of Nursing: KATIE LUCAS Start date: 4/1/2019 Medical director: Start date: / / Wound care specialist: Start date: / / Infection preventionist: Start date: / /
Ownership
CURENT OWNERSHIP: Owning corporation: SEYMOUR AL, LLC 600 THIRD AVE, 21ST FLOOR NEW YORK NY 10016 Ownership type: NON-PROFIT Officer(s): ALAN LITT JONATHAN LITT THOMAS LALLY LLC 125 HOLDCO LLC SALTAIRE PARTNERS INC SALTPAC HOLDING CO PREVIOUS OWNERSHIP CHANGES: Name of previous owner: SHIELDS AID OPCO LLC Date of last change of ownership: 1/10/2024
Bed Counts and Census
COMPREHENSIVE CARE BEDS: Number of Medicaid beds (NF): 0 Number of Medicare beds (SNF): 0 Number of Medicare/Medicaid beds (SNF/NF): 0 Number of non-certified comprehensive care beds (State Licensed only): 0 Total number of comprehensive care beds: 0 RESIDENTIAL CARE BEDS: Total number of residential beds: 47 Total number of beds in facility: 47 CENSUS: Facility census: 12 As reported by the facility on: 1/12/2024 Number of comprehensive care beds occupied in this facility. 0 As reported by the facility on: 1/12/2024 Residential care beds occupied: 12 As reported by the facility on: 1/12/2024 Alzheimer Beds: 0 Alzheimer Beds Occupied: 0 As reported by the facility on: / / Ventilator Beds: 0 Ventilator Beds Occupied: 0 As reported by the facility on: / /
Nurse Aide Training
NURSE AIDE TRAINING PROGRAM APPROVALS: Nurse aide training and competency evaluation program (NATCEP) approved: Nurse aide training and competency evaluation program (NATCEP) expires: Nurse aide training and competency evaluation program (NATCEP) banned: No Nurse aide training and competency evaluation program (NATCEP) ban expires: N/A CLINICAL TRAINING SITES: This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: NORTH LAWRENCE CAREER CENTER Approved: 7/6/2021 Terminated: N/A INDIANA HEALTH CAREERS VOCATIONAL TRAINING & TEST Approved: 7/15/2016 Terminated: 6/11/2021
Complaints
NUMBER OF SUBSTANTIATED COMPLAINTS: 
 
  Current year:  0
  Previous year:  0
  2 years previous:  0
State Licensure Surveys
The ISDH conducts a state licensure survey at each licensed residential facility
approximately once per year.  If state findings are cited on a survey, the
residential facility may be requested by the ISDH to complete a plan of
correction on how and when they will correct each state finding and who will be
responsible to ensure the corrections are made and will not reoccur in the future.
The plan of correction is generally submitted by the residential facility and
reviewed by the ISDH within fifteen (15) days of the survey.

To read an overview of the survey process, click here
   
NOTE:
    The residential consumer report survey information begins with surveys that
    have been completed on or after December 1, 2008.  Any survey performed prior
    to that date will not have any information in the state findings count rows or
    columns or will show zero.
10/4/2023 Most Recent 9/2/2022 2nd Most Recent 10/9/2019 3rd Most Recent
Number of state findings 2 0 0
State Average for the year of the survey (rounded to nearest whole integer). 4 4 3
Survey Report View Survey Report View Survey Report View Survey Report
Enforcement Actions
Survey History
The survey report is not posted until the report has been provided to the facility and their plan of correction submitted and approved. The survey report therefore will likely not be posted until four to six weeks after the exit date. In the grid below click on an event ID that is underlined to see the survey report for that event.
Event ID Survey Type Exit Date
B5XY11 Complaint 9/18/2024
98Q811 Relicensure 10/4/2023
G0O711 Relicensure 9/2/2022
 
 
Links and Resources
CMS nursing home compare page In addition to the information provided on this web site, the Centers for Medicare & Medicaid Services (CMS) has a web site which contains information on every Medicare and Medicaid certified nursing home in the country. The CMS nursing home survey results contain summary information about a facility's noncompliance of regulations regarding the care of residents found in the nursing homes. You can locate nursing homes in your area and find information about compliance with federal regulations. Resources and links to other organizations Choosing a Nursing Home Overview of the Survey Process State Wide Grouping of all Scores Overview of current comprehensive facility scores Spreadsheet of current comprehensive facility names and scores Legal Disclaimer for Long Term Care Reports.