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07/07/2021PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/CLIAAND PLAN OF CORRECTIONIDENTIFICATION NUMBER155162OMB NO. 0938039 (X2) MULTIPLE CONSTRUCTION A. BUILDING(X3) DATE SURVEY00COMPLETED06/17/2021B. WING STREET ADDRESS, CITY, STATE, ZIP CODNAME OF PROVIDER OR SUPPLIER600 WASHINGTON AVE WABASH, IN 46992AUTUMN RIDGE REHABILITATION CENTRE (X4) IDSUMMARY STATEMENT

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