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Complaint Investigation

Arlington Place Health Campus

May 29, 2026 · Indianapolis, IN · 1635 N Arlington Ave
Citations 2
CMS Rating 4/5
Beds 84
Provider ID 155816
Healthcare Facility
Arlington Place Health Campus
Indianapolis, IN  ·  View full profile →
Source Document
Official CMS Inspection Report (Medicare.gov)
Downloaded from CMS/Medicare.gov. Reflects what state inspectors documented and does not include the facility's plan of correction, which is submitted separately. Facilities may have taken corrective actions since this report was released.
Inspection Summary

ARLINGTON PLACE HEALTH CAMPUS in INDIANAPOLIS, IN — inspection on May 29, 2026.

Found 2 citations. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

Inspection Findings

FF0554
Resident Rights Deficiencies

blood sugar reading greater than 400 call the medical provider

A physician order, dated 3/16/26, indicated Resident D was to receive 20 units of fast-acting lispro insulin three times a day.

The staff was to hold the lispro if blood sugar was less than 110.

A physician order, dated 3/16/26, indicated Resident D was to receive 40 units of long-acting lantus insulin with breakfast.

The May 2026 Medication/Treatment Administration Record (MAR/TAR) indicated the resident had self- administered her insulin medications on 5/2/26, 5/8/26, 5/14/26, and 5/19/26.

The resident's clinical record did not include a self-medication assessment that was conducted, medical provider orders, or a care plan developed indicating resident was able to self-medicate her insulin medications.

An interview was conducted with the Director of Nursing Services (DNS) on 5/29/26 at 10:45 a.m.

She indicated Resident D chose the dosage amount and self-administered her insulin medications.

The medical provider was aware.

The staff did not conduct a self-medication assessment for Resident D.

A Guidelines for Self-Medication of Medications policy was provided by the DNS 5/28/26 at 3:41 p.m.

It indicated, Purpose Statement.

The purpose of this policy is to: To ensure the safe administration of medication for residents who request to self- medicate or when self- medication is a part of their plan of care.

Policy Guidelines for Self Administering of medications.

Residents requesting to self- medicate or has self-medication as a part of their plan of care shall be assessed using the observation Trilogy- Self Administration of Medication within the electronic health record.

Results of the assessment will be presented to the physician for evaluation and an order for self-medication.

The order should include the type of medication(s) the resident is able to self- medicate.e.: all oral meds, oral meds with the exception of., nebulizer treatment only, all medications including injection, oral, inhalers, drops, etc.6. A Self-Medication plan of care will be initiated and updated as indicated. 7.

The Assessment will be reviewed quarterly, and PRN with change of condition. 8.

The assessment will be documented in the EHR.

This citation is related to 3002975. 410 IAC (Indiana Administrative Code) 16.3.1-11

155816 05/29/2026

Arlington Place Health Campus 1635 N Arlington Ave Indianapolis, IN 46218

affect 70 of 70 residents that eat the food prepared and served from the kitchen.Findings include:An

dinner meals were always served cold.An observation was made of the main kitchen with the DM 11 on 5/28/26 at 12:26 p.m., Dietary Manager (DM) 11 utilizing a thermometer had taken the food temperatures of the prepared food to be served.

The smoked sausage had tempted 123 degrees Fahrenheit. DM 11 indicated the smoked sausage needed to be reheated. He preferred all food to be held at 150 degrees Fahrenheit, but the regulation stated food temperatures were to be held at 135 degrees Fahrenheit.During a dining observation on 5/28/26 at 11:57 a.m., Residents' N, O, P were sitting in the dining room waiting for the lunch meal.

They indicated the food that was supposed to be hot, was served cold at every meal in the dining room.An interview was conducted with Resident M on 5/28/26 at 12:38 p.m.

She indicated resident council discussed food temperature concerns at every meeting.

The food that was suppose to be hot, was normally served cold.A hot and cold holding policy was provided by the Director of Nursing Services (DNS) on 5/28/26 at 3:41 p.m. It indicated, Purpose.

The purpose of this policy is to: Give guidelines to holding temperatures.Procedure.Hot food in the steam table should be at least 135 or higher degrees Fahrenheit and arrive approximately at greater than or equal to 120 degrees Fahrenheit when the resident is served.This citation is related to Intake

  • 410 IAC (Indiana Administrative Code) 16.2-3.1-21(a)(2)

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in INDIANAPOLIS, IN, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from ARLINGTON PLACE HEALTH CAMPUS or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


More Reports

About This Inspection Report

Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.

Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.

Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.