LeadingAge Kentucky
2501 Nelson Miller Parkway
Louisville, KY 40223
502-992-4380 | 502-992-4390 - FAX



Membership Survey

Facility Name:  
Street Address:  
City:  
County:  
Zip Code:  
Phone Number:  
Fax Number:  
Web Address:  
   
Bed and Unit Data:
  (list number of beds)
Skilled Nursing: Nursing Home:
Nursing Facility: Assisted Living:
Intermediate Care: Independent Living:
Personal Care:    
 
Facility Positions
Position First Name Last Name Email Address
Administrator
Assitant Administrator
Housing Manager
Business Office Manager
Director of Nursing
Assitant DON
Medical Director
Activity Director
MDS Coordinator
Staff Development Coordinator
Pastoral Care
Director Human Resources
Director of Quality Assurance
Medical Records Director
Social Services Director
 
Parent Agency/Multi Facility Organization:  
Street Address:  
City:  
State:  
County:  
Zip Code:  
Phone Number:  
Fax Number:  
Web Address:  
 
Parent Agent Positions
Position First Name Last Name Email Address
Chief Executive Officer/ President
Chief Financial Officer
Chief Operations Officer
Chief Information Officer
Director of Human Resources
Director of Marketing
Director of Development

2501 Nelson Miller Parkway
Louisville, KY 40223
502-992-4380
502-992-4390 - FAX
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