Created on: 07/25/2025
Posted to the Web on: 08/06/2025
Basic Information
FACILITY CONTACT INFORMATION:
Address: 1129 PARKWAY AVENUE
City: ELKHART
Telephone: (574) 966-8800
Web Site:
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
LICENSE INFORMATION:
License number: 25-014916-1
License effective date: 07/01/2025
License expiration date: 06/30/2026
Administration and Staff
Administrator: TARA CARNEY
Start date: 02/17/2025
Director of Nursing: MARY LYCZYNSKI
Start date: 05/22/2025
Medical director:
Start date: / /
Wound care specialist:
Start date: / /
Infection preventionist:
Start date: / /
Ownership
CURENT OWNERSHIP:
Owning corporation: ELKHART OPERATIONS, LLC
4423 PHEASANT RIDGE ROAD, SUITE 301
ROANOKE VA 24014
Ownership type: PROFIT
Officer(s): JAMES R SMITH
HUNTER D SMITH
JAMES R SMITH TRUST FOR HUNTER D
JAMES R SMITH TRUST FOR ROSS P
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: 202
Total number of beds in facility: 202
CENSUS:
Facility census: 0
As reported by the facility on: / /
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: / /
Residential care beds occupied: 0
As reported by the facility on: / /
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:
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.
01/28/2025 Most Recent
02/14/2024 2nd Most Recent
02/15/2023 3rd Most Recent
Number of state findings
10
11
15
State Average for the year of the survey (rounded to nearest whole integer).
