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PRINTED 01/11/2017 FORM APPROVED Indiana State Department of Health STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION X1 PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER BRENTWOOD AT HOBART X4 ID PREFIX TAG A. Complaint IN00218724- Substantiated. No deficiencies related to the allegations are cited. Survey date January 6 2017 Facility number 002627 Provider number 002627 AIM number N/A Residential Census 88 Sample 5 Brentwood at Hobart was found to be in compliance with 410 IAC 16. BUILDING X3...

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