Created on: 07/25/2025
Posted to the Web on: 08/06/2025
Basic Information
FACILITY CONTACT INFORMATION:
Address: 12523 AUBURN ROAD
City: FORT WAYNE
Telephone: (260) 637-2830
Web Site:
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
LICENSE INFORMATION:
License number: 24-014512-1
License effective date: 11/01/2024
License expiration date: 10/31/2025
Administration and Staff
Administrator: EMILY NELSON
Start date: 10/30/2023
Director of Nursing: TAYLOR GAGE
Start date: 12/02/2024
Medical director:
Start date: / /
Wound care specialist:
Start date: / /
Infection preventionist:
Start date: / /
Ownership
CURENT OWNERSHIP:
Owning corporation: EV FW LIMITED PARTNERSHIP
12523 AUBURN ROAD
FORT WAYNE IN 46845
Ownership type: PROFIT
Officer(s): CHARLES ALLEN
BRIAN POULIN
WILLIAM HOULIHAN
NATIONAL ASSOC PNC BANK
SLP CORPORATION COLUMBIA HOUSING
LLC EV FORT WAYNE
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: N/A
Date of last change of ownership: N/A
Bed Counts and Census
COMPREHENSIVE CARE BEDS:
Number of Medicaid beds (NF): 0
Number of Medicare beds (SNF): 0
Number of Medicare/Medicaid beds (SNF/NF): 0
Number of non-certified comprehensive care beds (State Licensed only): 0
Total number of comprehensive care beds: 0
RESIDENTIAL CARE BEDS:
Total number of residential beds: 206
Total number of beds in facility: 206
CENSUS:
Facility census: 126
As reported by the facility on: 07/17/2025
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 07/17/2025
Residential care beds occupied: 126
As reported by the facility on: 07/17/2025
Alzheimer Beds: 0
Alzheimer Beds Occupied: 0
As reported by the facility on: / /
Ventilator Beds: 0
Ventilator Beds Occupied: 0
As reported by the facility on: / /
Nurse Aide Training
NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved:
Nurse aide training and competency evaluation program (NATCEP) expires:
Nurse aide training and competency evaluation program (NATCEP) banned: No
Nurse aide training and competency evaluation program (NATCEP) ban expires: N/A
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites:
COTTON CARE LLC
Approved: 10/29/2021
Terminated: N/A
RISE UP HEALTH CARE ACADEMY
Approved: 07/22/2024
Terminated: N/A
Complaints
NUMBER OF SUBSTANTIATED COMPLAINTS:
Current year: 0
Previous year: 0
2 years previous: 0
State Licensure Surveys
The ISDH conducts a state licensure survey at each licensed residential facility
approximately once per year. If state findings are cited on a survey, the
residential facility may be requested by the ISDH to complete a plan of
correction on how and when they will correct each state finding and who will be
responsible to ensure the corrections are made and will not reoccur in the future.
The plan of correction is generally submitted by the residential facility and
reviewed by the ISDH within fifteen (15) days of the survey.
To read an overview of the survey process, click hereNOTE:
The residential consumer report survey information begins with surveys that
have been completed on or after December 1, 2008. Any survey performed prior
to that date will not have any information in the state findings count rows or
columns or will show zero.
01/30/2025 Most Recent
03/11/2024 2nd Most Recent
03/30/2023 3rd Most Recent
Number of state findings
2
4
3
State Average for the year of the survey (rounded to nearest whole integer).
