PILGRIM MANOR
222 PARKVIEW ST
PLYMOUTH, IN, 46563
5749369943
CCN: 155073
2
Overall1
Health2
Staffing5
QualitySpecial FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
| Name | Role | % |
|---|---|---|
| ADAMS COUNTY MEMORIAL HOSPITAL | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% |
| NBH BANK | 5% OR GREATER MORTGAGE INTEREST | NOT APPLICABLE |
| PILGRIM MANOR OPERATIONS | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| BORNE-BAUMAN, CANDICE | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| COMBS, JAMES | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| FLUECKIGER, RUSSELL | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| HOLM, BYRON | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| LEHMAN, SCOTT | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| MACKLIN, LARRY | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| MCINTIRE, DAVID | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| SMITH, SCOTT | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| SPRUNGER, KYLE | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| WHEELER, DANE | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| ADAMS COUNTY MEMORIAL HOSPITAL | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
Health Deficiencies (26)
2024-11-27 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
E
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
F761 · 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.
D
F755 · Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
F695 · Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
D
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
G
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
F656 · 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.
D
F641 · Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
D
F558 · Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
D
F550 · Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
2024-08-28 · Health
D
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
D
F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
F607 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
D
F604 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
2023-12-22 · Health
F
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
F686 · Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
D
F656 · 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.
2023-02-15 · Health
D
F761 · 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.
D
F758 · Pharmacy Service Deficiencies
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
D
F693 · Quality of Life and Care Deficiencies
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
D
F692 · Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
D
F686 · Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
F656 · 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.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day3.68
3.25
RN Hrs/Resident/Day0.54
0.65
LPN Hrs/Resident/Day0.81
0.48
CNA Hrs/Resident/Day2.33
2.13
PT Hrs/Resident/Day0.12
0.06
Data as of 2026-03-01