Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
MAJESTIC CARE OF AVON
 
NURSING HOME
SKILLED NURSING FACILITY / NURSING FACILITY DISTINCT PART
Created on: 3/21/2025
 
Posted to the Web on: 4/2/2025
 
 



Basic Information

FACILITY CONTACT INFORMATION:
Address: 445 S COUNTY ROAD 525 E
City: AVON
Telephone: (317) 745-2522
Web Site:  
 
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
 
LICENSE INFORMATION:
  License number: 24-000231-1
  License effective date: 12/1/2024
  License expiration date: 11/30/2025
 


Administration and Staff

Administrator: ROGER PIOTROWICZ
  Start date: 2/24/2025
 
Director of Nursing: MORGAN CRAWFORD
  Start date: 5/13/2024
 
Medical director:  
  Start date:   /  /  
 
Wound care specialist:  
  Start date:   /  /  
 
Infection preventionist:  
  Start date:   /  /  
 


Ownership

CURENT OWNERSHIP:
 
Owning corporation: PULASKI MEMORIAL HOSPITAL
616 E 13TH STREET
WINAMAC IN 46996
 
Ownership type:  NON-PROFIT
 
Officer(s): MICHAEL MCKAY
            LINDA WEBB
            CHARLES HUTTON
            GREGG MALOTT
            CLINT KAUFFMAN
            STEVE JAROSINSKI
            ADAM BENNETT
            JENNIFER SMITH
            TAYLOR WHITE
            JENNIFER MELLON
 
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: HENDRICKS COUNTY HOSPITAL
Date of last change of ownership: 12/31/2020
 


Bed Counts and Census

COMPREHENSIVE CARE BEDS:
Number of Medicaid beds (NF):                     0
Number of Medicare beds (SNF):                    11
Number of Medicare/Medicaid beds (SNF/NF):        129
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     140
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            0
 
Total number of beds in facility:            140
 
CENSUS:
Facility census:  79
As reported by the facility on: 1/22/2025 
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 1/22/2025 
 
Residential care beds occupied:  0
As reported by the facility on: 1/22/2025 
 
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:   /  /  
 


Sprinklers and Smoke Detectors

This facility is: FULLY SPRINKLERED
 
Number of comprehensive care resident rooms: 79
Number of comprehensive care resident rooms with battery 
                    operated smoke detectors: 65
Number of comprehensive care resident rooms 
             with hard wired and/or wireless smoke detectors: 14
 
  If hard wired and/or wireless smoke detectors are provided in resident's room, do they:
    (A) Provide a visual and audible signal at the nurses'stations that attend each room? - Yes
    (B) Transmit to a central station service - Yes
    (C) Connect to the health facility's fire alarm system - Yes
 
Person completing form - RONALD E WELDY
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. GENERAL COUNSEL
Date form completed - 4/19/2022
 


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: Yes
Nurse aide training and competency evaluation program (NATCEP) ban expires: 7/1/2023
 
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: 
     AREA 31 CAREER CENTER
         Approved: 11/30/1998
         Terminated: 3/14/2011
     IVY TECH COMMUNITY COLLEGE
         Approved: 11/23/1998
         Terminated: 3/14/2011
     AREA 31 CAREER CENTER
         Approved: 12/22/2023
         Terminated: N/A
 


Complaints

NUMBER OF SUBSTANTIATED COMPLAINTS: 
 
  Current year:  0
  Previous year:  0
  2 years previous:  2

 


Facility Report Card



 


 
3/1/2020 Current QTR
12/1/2019 Previous QTR
9/1/2019 Previous QTR
6/1/2019 Previous QTR


Report Card Score
150
225
336
362


Rank of Score
94
86
57
47


Average Score
302
296
295
296


 
*Facility report card scores have not been updated since March 1, 2020 due to changes in the survey process during the ongoing COVID-19 pandemic. 
The facility report card score is calculated four times per calendar year 
for the two most recent nursing home health surveys.  The facility report card score 
also includes all complaint surveys, life safety code surveys, emergency preparedness surveys, 
and any follow-up surveys that occur within the two most recent nursing home health surveys. 
The facility report card score ranges from 500 to 0, with 500 being the best score possible. 
 
View the Scope and Severity grid
 
View the scoring methodology
 



Overview of Survey findings




 
 The Most Recent Set
 2ND Most Recent Set
 3RD Most Recent Set

Immediate Jeopardy
No
No
Yes


 Substandard Quality of Care 
No
No
Yes


Administrator Change
Yes
No
Yes


Owner Change
No
No
No


Number of Substantiated Complaints With Deficiencies
0
0
0


Deficiency Free Standard Health Survey
No
No
No


 
    The term 'Recent Set' referenced above relates to the referenced annual survey,
    and any other surveys performed between it and the previous annual survey.
 

 


Enforcement Actions

 
Federal Certification Actions Imposed
     Directed Plan of Correction
     Date Imposed: 4/9/2022  Date Ended: 4/4/2022
 
Date terminated from Medicare/Medicaid: N/A
 


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

KOB611
Complaint
11/22/2024


2WCI11
Complaint
10/31/2024


Q1K122
Follow Up, Life Safety Code, Recertification
10/10/2024


Q1K112
Recertification, Follow Up, State Licensure
9/12/2024


Q1K121
Recertification, Life Safety Code
8/26/2024


Q1K111
Recertification, State Licensure
8/8/2024


Z02Q21
Life Safety Code, Other
6/19/2024


8KFG12
Complaint, Follow Up
4/30/2024


4J8U12
Complaint, Follow Up
4/30/2024


4J8U11
Complaint
3/13/2024


8KFG11
Complaint
2/6/2024


LNCK11
Complaint
9/14/2023


XXJ422
Follow Up, Life Safety Code, Recertification
9/14/2023


XXJ412
Recertification, Follow Up, State Licensure
9/5/2023


XXJ421
Recertification, Life Safety Code
7/17/2023


XXJ411
Recertification, State Licensure
6/30/2023


8RL812
Complaint, Follow Up
6/13/2023


8RL811
Complaint
4/28/2023


MF7V12
Complaint, Follow Up
4/25/2023


ZM6N11
Complaint
3/16/2023


MF7V11
Complaint
2/17/2023


O52F12
Complaint, Follow Up
11/3/2022


W9LX11
Complaint
10/19/2022


O52F11
Complaint
9/14/2022


W4L722
Recertification, Follow Up, Life Safety Code
5/25/2022


PGEN12
Complaint, Follow Up, Other
4/12/2022


W4L712
Recertification, Complaint, Follow Up, State Licensure
4/12/2022


W4L721
Recertification, Life Safety Code
3/28/2022


 
 


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.