WOODLAND MANOR
CONSUMER REPORT Created on: 01/10/2013 Posted to the Web on: 01/23/2013 Facility ProfileReturn to Search Page
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Basic Information Address: 343 S NAPPANEE ST City: ELKHART Telephone: (574) 295-0096 View location on map Most recent name change: N/A Date of most recent name change: N/A Owning corporation: ADAMS COUNTY MEMORIAL HOSPITAL 1100 MERCER AVENUE DECATUR IN 46733 Ownership type: OTHER Officer(s): ROBERT JUDGE DENNIS BIEBERICH RUSS FLUECKIGER LARRY MACKLIN DANE WHEELER THOMAS NORDWICK JO EIDAM Name of previous owner: ELKHART HEALTH CARE CENTER INVESTORS LLC Date of last change of ownership: 05/01/2012 Administrator: KELLY DUHAIME Administrator start date: 07/12/2004 License number: 12-000034-1 License effective date: 05/01/2012 License expiration date: 04/30/2013 This facility is: FULLY SPRINKLERED Number of comprehensive care resident rooms: 48 Number of comprehensive care resident rooms with battery operated smoke detectors: 48 Number of comprehensive care resident rooms with hard wired and/or wireless smoke detectors: 0 Person completing form - KELLY DUHAIME Title - ADMINISTRATOR Date form completed - 10/16/2012 Nurse Aide Training Competency Evaluation Program (NATCEP) NATCEP approved: 05/01/2012 NATCEP expires: 04/30/2013 NATCEP banned: YES NATCEP ban expires: 02/06/2007 This facility is a Clinical training site for the following NAT classroom sites: EMERGENCY MEDICAL SOLUTIONS, LLC Approved: 10/06/2009 Terminated: N/A IVY TECH COMMUNITY COLLEGE-ELKHART Approved: 03/14/2012 Terminated: N/A ELKHART AREA CAREER CENTER-HEALTH Approved: 01/27/1997 Terminated: N/A Beds # of Medicaid beds (NF): 0 # of Medicare beds (SNF): 0 # of Medicare/Medicaid beds (SNF/NF): 80 Total number of comprehensive care beds: 80 # of non-certified comprehensive care beds: 0 Total number of residential beds: 0 Total number of beds in facility: 80 Facility census: 61 as of: 03/01/2012 Results of Surveys Date of last annual health survey: 02/28/2012 In substantial compliance on most recent annual health survey? NO If no, date facility achieved substantial compliance from annual health survey: 03/30/2012 Currently found in substantial compliance? Yes # of substantiated complaints: current year 0 # of substantiated complaints: previous year 1 # of substantiated complaints: 2 years previous 0 Substandard quality of care designations: 02/07/2005 Immediate jeopardy designations: N/A State Licensure Actions Event ID: ZRD311 Action - Citation / Fine Notice to facility: 04/15/2005 Appeal: N/A Action Cease/Recind: 05/10/2005 Case Closed: 05/10/2005 Initial Amount: $5000 Event ID: 0O3U11 Action - Citation / Fine Notice to facility: 06/23/2003 Appeal: 07/11/2003 Action Cease/Recind: 02/08/2005 Case Closed: 02/08/2005 Initial Amount: $3750 Event ID: 8PCD11 Action - Citation / Fine Notice to facility: 09/24/2001 Appeal: N/A Action Cease/Recind: 10/11/2001 Case Closed: 10/11/2001 Initial Amount: $3500 Event ID: Notice to facility: 02/24/2000 Appeal: 03/15/2000 Action Cease/Recind: 06/23/2000 Case Closed: 06/23/2000 Initial Amount: $0 Event ID: Action - Citation / Fine Notice to facility: 08/06/1998 Appeal: 09/01/1998 Action Cease/Recind: 11/09/1999 Case Closed: 11/09/1999 Initial Amount: $5000 Federal Certification Actions Imposed Date terminated from Medicare.Medicaid: N/A WOODLAND MANOR
CONSUMER REPORT Created on: 01/10/2013 Posted to the Web on: 01/23/2013 Facility ProfileReturn to Search Page