01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-05-12 | 7 | 2025-05-12 | 0 |
| Cycle 2 | 2024-05-03 | 7 | 2024-05-03 | 0 |
| Cycle 3 | 2022-10-20 | 3 | 2022-10-20 | 0 |
CMS CCN 1554612026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Prairie Village Nursing And Rehabilitation
801 S Sr 57 · Washington, IN 47501 · Daviess County
Certified beds65CMS provider file
Recent citation rows17current 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
17 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 2 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-05-12 · HEALTHF0553Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
Correction field: Deficient, Provider has date of correction · 2025-06-102025-05-12 · 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 · 2025-06-102025-05-12 · HEALTHF0605Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Correction field: Deficient, Provider has date of correction · 2025-06-102025-05-12 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2025-06-102025-05-12 · HEALTHF0744Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
Correction field: Deficient, Provider has date of correction · 2025-06-102025-05-12 · 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 · 2025-06-102025-05-12 · HEALTHF0921Severity E · pattern; 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 · 2025-06-102024-05-03 · HEALTHF0550Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Correction field: Deficient, Provider has date of correction · 2024-05-302024-05-03 · 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 · 2024-05-302024-05-03 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2024-05-302024-05-03 · HEALTHF0657Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Correction field: Deficient, Provider has date of correction · 2024-05-302024-05-03 · HEALTHF0727Severity F · widespread; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Correction field: Deficient, Provider has date of correction · 2024-05-302024-05-03 · HEALTHF0761Severity E · pattern; 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 · 2024-05-302024-05-03 · HEALTHF0880Severity E · pattern; 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 · 2024-05-302022-10-20 · HEALTHF0583Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
Correction field: Deficient, Provider has date of correction · 2022-11-112022-10-20 · 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 · 2022-11-112022-10-20 · HEALTHF0755Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Correction field: Deficient, Provider has date of correction · 2022-11-1103 / 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
- DRUMMER, CARLIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2017
- HANIFY, THOMASIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2022
- HORN, BRENDAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/01/2023
- LAZARD, ROBERTIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/29/2021
- MANTRAVADI, GEETAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/21/2021
- PAYNE, MONICAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 08/09/2021
- BABCOCK, PAULIndividual · CORPORATE OFFICERNOT APPLICABLE · since 09/30/2020
- CAINE, VIRGINIAIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/10/1994
- HARRIS, LISAIndividual · CORPORATE OFFICERNOT APPLICABLE · since 12/22/2003
- AMERICAN SENIOR COMMUNITIES LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 07/01/2015
- BURLA, KIRANIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/07/2019
- DICE, MARKIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/01/2023
- GOODWIN, GARYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/03/2019
- O'NIONES, ROBERTIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/29/2024
- VAN CAMP, STEVENIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/01/2023
- AMERICAN SENIOR COMMUNITIES LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 06/15/2026
- BURLA, KIRANIndividual · ADP OF THE SNFNOT APPLICABLE · since 06/15/2026
- DICE, MARKIndividual · ADP OF THE SNFNOT APPLICABLE · since 06/01/2023
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 hours3.87per resident day
RN hours0.69per resident day
Weekend nurse hours3.16per resident day
Staff turnover23.3%CMS reported field