01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-01-12 | 4 | 2026-01-12 | 0 |
| Cycle 2 | 2024-11-12 | 6 | 2024-11-12 | 0 |
| Cycle 3 | 2023-08-22 | 17 | 2023-08-22 | 1 |
CMS CCN 1558152026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Clearvista Lake Health Campus
8405 Clearvista Place · Indianapolis, IN 46256 · Marion County
Certified beds70CMS provider file
Recent citation rows28current CMS citation release
Penalty rows0current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
28 rows in the current release
1 rows carry G–L scope/severity codes; 0 carry J–L. 7 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-01-12 · HEALTHF0554Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Allow residents to self-administer drugs if determined clinically appropriate.
Correction field: Deficient, Provider has date of correction · 2026-01-302026-01-12 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2026-01-302026-01-12 · HEALTHF0697Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe, appropriate pain management for a resident who requires such services.
Correction field: Deficient, Provider has date of correction · 2026-01-302026-01-12 · HEALTHF0812Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2026-01-302024-11-12 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2024-11-252024-11-12 · HEALTHF0697Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe, appropriate pain management for a resident who requires such services.
Correction field: Deficient, Provider has date of correction · 2024-11-252024-11-12 · HEALTHF0761Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Correction field: Deficient, Provider has date of correction · 2024-11-252024-11-12 · HEALTHF0842Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2024-11-252024-11-12 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2024-11-252024-11-12 · HEALTHF0921Severity D · isolated; potential for more than minimal harm
Environmental Deficiencies
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Correction field: Deficient, Provider has date of correction · 2024-11-252024-06-21 · HEALTHF0584Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Correction field: Deficient, Provider has date of correction · 2024-07-12 · complaint2024-06-21 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2024-07-12 · complaint2024-06-21 · HEALTHF0842Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2024-07-12 · complaint2024-06-21 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2024-07-12 · complaint2024-05-03 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2024-05-20 · complaint2023-12-12 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2023-12-29 · complaint2023-08-22 · HEALTHF0554Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Allow residents to self-administer drugs if determined clinically appropriate.
Correction field: Deficient, Provider has date of correction · 2023-09-222023-08-22 · HEALTHF0559Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made.
Correction field: Deficient, Provider has date of correction · 2023-09-222023-08-22 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2023-09-222023-08-22 · HEALTHF0661Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
Correction field: Deficient, Provider has date of correction · 2023-09-222023-08-22 · HEALTHF0677Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Correction field: Deficient, Provider has date of correction · 2023-09-222023-08-22 · HEALTHF0684Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2023-09-222023-08-22 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2023-09-222023-08-22 · HEALTHF0698Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Correction field: Deficient, Provider has date of correction · 2023-09-2203 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- WITHAM MEMORIAL HOSPITALOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 07/01/2015
- BAYSTON, BRETTIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2023
- BRAND, JOHNIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2015
- CASTETTER, ANDREAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2023
- HAWKINS, CLAUDEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 09/09/2013
- HORNBECKER, MICHAELIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2024
- REAGAN, JULIEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 09/25/2024
- BARDOCZI, STEPHENIndividual · CORPORATE OFFICERNOT APPLICABLE · since 09/03/2013
- BRAVERMAN, KELLYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 12/01/2021
- SELLERS, DANIELIndividual · CORPORATE OFFICERNOT APPLICABLE · since 06/20/2024
- RHS PARTNERS OF CASTLETON LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 07/01/2015
- MEVZEK, STACYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/18/2024
- BARNEY, LEIGHIndividual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNFNOT APPLICABLE · since 09/19/2025
- DAVIS, DAVIDIndividual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNFNOT APPLICABLE · since 09/19/2025
- AMERICAN HEALTHCARE REIT HOLDINGS LPOrganization · ADP OF THE SNFNOT APPLICABLE · since 10/01/2021
- AMERICAN HEALTHCARE REIT INCOrganization · ADP OF THE SNFNOT APPLICABLE · since 10/01/2018
- GAHC3 TRILOGY JV LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 12/01/2015
- GAHC4 TRILOGY JV LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 10/01/2018
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours3.75per resident day
RN hours0.83per resident day
Weekend nurse hours3.05per resident day
Staff turnover50.0%CMS reported field
06 / LOCAL RECORDS
Open the Indianapolis ledger →Other published facilities nearby
Allison Pointe Healthcare Center144 beds · CMS overall 2/583 citation rowsAlpha Home - A Waters Community86 beds · CMS overall 1/557 citation rowsAltenheim Health & Living Community87 beds · CMS overall 4/538 citation rowsAmerican Village150 beds · CMS overall 3/573 citation rowsArlington Place Health Campus84 beds · CMS overall 4/536 citation rowsBethany Village100 beds · CMS overall 2/539 citation rowsBrickyard Healthcare - Brookview Care Center136 beds · CMS overall 3/543 citation rowsBrickyard Healthcare - Churchman Care Center115 beds · CMS overall 4/547 citation rows