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Complaint Investigation

Zionsville Meadows

August 21, 2025 · Zionsville, IN · 675 S Ford Rd
Citations 3
CMS Rating 4/5
Beds 167
Provider ID 155620
Healthcare Facility
Zionsville Meadows
Zionsville, IN  ·  View full profile →
Inspection Summary

ZIONSVILLE MEADOWS in ZIONSVILLE, IN — inspection on August 21, 2025.

Found 3 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.

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Inspection Findings

FF0677
Quality of Life and Care Deficiencies
Potential for More Than Minimal Harm

care was provided daily as part of the resident's morning care.During the exit conference on 8/20/25 at 11:40 a.m., the DNS indicated there was a large quantity of bathing and oral supplies stored on the secured memory care unit.

The supplies were within easy access to staff providing care to residents on the unit.

There were shower/bathing sheets that documented the residents were receiving routine baths and oral care.

The DON indicated she had observed supplies for bathing and oral care in the resident's rooms and believed they had been taking care of. On 8/21/25 at 9:45 a.m., the Executive Director provided an AM Care Nursing Skills Competency check list, dated 3/2023.

The procedure steps indicated, .7.

Assist resident with oral hygiene [including denture care if applicable] On 8/21/25 at 9:45 a.m., the Executive Director provided a HS/PM Care Nursing Skills Competency check list, dated 3/2023.

The procedure steps indicated, .8.

Assist resident with oral hygiene [including denture care if applicable] This citation relates to Intake 2588701.3.1-38(a)(3)

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

08/21/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Zionsville Meadows

675 S Ford Rd Zionsville, IN 46077

SUMMARY STATEMENT OF DEFICIENCIES

Based on observation, interview, and record review, the facility failed to ensure all aerosol disinfectant sprays and medications were secured in the resident rooms, for 3 random observations for potential accidents (Residents H, M, and N).

Findings include:On 8/20/25 at 12:48 p.m., during the initial facility tour observations included, a.

Resident H, residing on the secured memory care unit, had a large can of generic disinfectant spray.

The disinfectant spray was visible from the hallway door sitting on the top shelf of an open closet.

The can's caution label indicated, store preferably under lock.

Hazardous if absorbed through the skin or inhaled. b.

Resident M, who had a roommate, had a large can of Febreze spray, an odor eliminator.

The spray can was sitting on top of a dresser, visible from the hallway.

The can's caution label indicated, do not spray toward face, if eye contact occurred, rinse well with water and seek medical attention as needed. c.

Resident N, had a bottle of selenium sulfide lotion 2.5 %, an antifungal medicated shampoo.

The bottle with the top missing was observed sitting on top of a dresser, visible from the hallway.

The resident's clinical record lacked documentation of an order for may keep medications at bedside. d.

Resident N, who was in the hospital, had an opened bottle of Pepto Bismol liquid, a medication used to treat digestive ailments.

The bottle was observed sitting on her bedside stand and had no prescription label with the resident's name or direction for use.

The resident's clinical record lacked documentation of an order for Pepto Bismol or for an order for may keep medications at bedside. On 8/21/25 at 10:45 a.m., a second observation of the aerosol sprays in the resident rooms and medication at bedside with the Executive Director, who indicated the items had not been stored properly. On 8/21/25 at 9:45 a.m., the Executive Director provided a Safety - Cleaning Products policy, dated 8/17, and indicated the policy was the one currently being used by the facility.

The policy indicated, All cleaning chemicals must be kept in locked storage rooms when not in use.Cleaning chemicals in remote locations, i.e. activity room, shower/spa rooms, nurse's stations, public areas, etc.should be in locked storage when not in use.On 8/21/25 at 11:35 a.m., the Director of Nursing Services (DNS) provided a Medication Storage and Expiration Policy, dated 11/2024, and indicated the policy was the one currently being used by the facility.

The policy indicated, Medications including treatment items should be stored in a locked cabinet/cart or locked medication room that is inaccessible by residents and visitors.20.

Facility should not provide medications without a Physician's order.21.

Bedside medications should be stored in a locked compartment within the resident's room.This citation relates to Intake 2588701.3.1-45(a)(1)

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

08/21/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Zionsville Meadows

675 S Ford Rd Zionsville, IN 46077

SUMMARY STATEMENT OF DEFICIENCIES

Based on observation, and interview, the facility failed to maintain a clean, safe, and sanitary environment on 1 of 4 hallways (Auguste's Cottage - a secured memory care unit) observed for cleanliness.

Findings include:On 8/20/25 at 12:48 p.m., during the initial facility tour observations included:a. A PTAC heating and cooling unit in the memory care unit dining room, was observed in the wall under the dining room window.

The plaster board base under the PTAC unit was chipped, pealing, and white debris was observed on the floor. b. A cove base strip of trim that had been installed where the wall met the floor, was pulled from the wall, exposing chipped paint to the wall. An approximate 3 foot of cove base, still attached to the wall on one end, was observed laying on the floor near dining room tables where residents walked to be seated for meals and activities. b. An electrical outlet with a missing face plate was observed in the hallway on the front side of the nurse's desk.

The exposed outlet was observed to be approximately 1 foot from the floor, and within sight and reach of anyone ambulating by or seated in a wheelchair. On 8/20/25 at 12:56 p.m., observation of a supply storage area located in the back hallway of the secured memory care unit.

Supplies were observed to be disorganized, some boxes on the floor versus pallets, and packages of oxygen tugging and boxes of bandages on the floor in the aisle. An environmental safety policy was not received during the survey process.

This citation relates to Intake 2588701.3.1-19(f)(5)

Facility ID:

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 ZIONSVILLE, 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 ZIONSVILLE MEADOWS or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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