Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record
COUNTRYSIDE MEADOWS
AVON, IN · 171 certified beds · Last Life Safety survey December 16, 2025
CMS Certification Number 155792 · first certified July 2011
Ownership
Operated by AMERICAN SENIOR COMMUNITIES · For profit - Corporation
No change of ownership on CMS record since January 1, 2016, when the records begin.
Position within IN
10 citations — more than 29% of the 507 certified nursing homes in IN. Compared within IN rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated
The latest survey found 6 citations; the earlier surveys in the window averaged 2. With 3 surveys on file this is a direction of travel, not a conclusion.
When is the next survey likely?
The window opens November 2026 — about 2 months from now. This facility’s last Life Safety survey was December 2025. Facilities in IN are typically surveyed 11–14 months after the last one (median 13), measured over 883 consecutive surveys in the last two years of CMS records.
A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured
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Emergency preparedness
4 of the 10 citations on file are Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index
Physical environment (health survey)
4 physical-environment citations on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 10 Life Safety citations above. The Physical Environment Index
How that compares
Compared with the median facility in IN, and nationally. Surveyors differ markedly between states, so the IN figure is the meaningful one.
| Measure | Citations |
|---|---|
| This facility | 10 |
| Median facility in IN | 15 |
| Median facility nationally | 11 |
Survey history
| Survey date | Citations |
|---|---|
| August 31, 2023 | 2 |
| October 7, 2024 | 2 |
| December 16, 2025 | 6 |
Most-cited tags
| Tag | What the surveyor checks | Times cited | Last cited |
|---|---|---|---|
| K-0324 | Provide properly protected cooking facilities. | 1 | 2024-10-07 |
| E-0013 | Develop Emergency Preparedness policies and procedures. | 1 | 2025-12-16 |
| E-0036 | Establish emergency prep training and testing. | 1 | 2025-12-16 |
| E-0004 | Develop and maintain an Emergency Preparedness Program (EP). | 1 | 2025-12-16 |
| K-0921 | Ensure that testing and maintenance of electrical equipment is performed. | 1 | 2025-12-16 |
| E-0029 | Develop a communication plan. | 1 | 2025-12-16 |
| K-0211 | Keep aisles, corridors, and exits free of obstruction in case of emergency. | 1 | 2025-12-16 |
| K-0711 | Provide a written emergency evacuation plan. | 1 | 2024-10-07 |
What the citations cover
- Emergency Preparedness Deficiencies 4
- Egress Deficiencies 2
- Miscellaneous Deficiencies 2
- Smoke Deficiencies 1
- Other 1
| Category | Citations |
|---|---|
| Emergency Preparedness Deficiencies | 4 |
| Egress Deficiencies | 2 |
| Miscellaneous Deficiencies | 2 |
| Smoke Deficiencies | 1 |
| Gas, Vacuum, and Electrical Systems Deficiencies | 1 |
Every citation on file
As published by CMS, newest survey first. Descriptions are CMS’s own wording.
December 16, 2025 — 6 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| E-0004 | Develop and maintain an Emergency Preparedness Program (EP). | Deficient, Provider has date of correction (January 29, 2026) |
| E-0013 | Develop Emergency Preparedness policies and procedures. | Deficient, Provider has date of correction (January 28, 2026) |
| E-0029 | Develop a communication plan. | Deficient, Provider has date of correction (January 29, 2026) |
| E-0036 | Establish emergency prep training and testing. | Deficient, Provider has date of correction (January 29, 2026) |
| K-0211 | Keep aisles, corridors, and exits free of obstruction in case of emergency. | Deficient, Provider has date of correction (January 29, 2026) |
| K-0921 | Ensure that testing and maintenance of electrical equipment is performed. | Deficient, Provider has date of correction (January 29, 2026) |
October 7, 2024 — 2 citations
August 31, 2023 — 2 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| K-0222 | Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements. | Deficient, Provider has date of correction (September 18, 2023) |
| K-0761 | To conduct inspection, testing and maintenance of fire doors by qualified individuals. | Deficient, Provider has date of correction (September 18, 2023) |
Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.