MILLER'S MERRY 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: 500 WALKERTON TR City: WALKERTON Telephone: (574) 586-3133 View location on map Most recent name change: N/A Date of most recent name change: N/A Owning corporation: MILLER'S HEALTH SYSTEMS INC 1690 S COUNTY RD WARSAW IN 46580 Ownership type: PROFIT Officer(s): VERNON RICHARD MILLER R JAMES MILLER BARBARA MILLER BEVERLY MILLER PATRICK BOYLE LORI HAUG TINA ROBINSON Name of previous owner: N/A Date of last change of ownership: N/A Administrator: CHRISTY CLARK Administrator start date: 10/08/2009 License number: 12-000431-1 License effective date: 07/01/2012 License expiration date: 06/30/2013 This facility is: FULLY SPRINKLERED Number of comprehensive care resident rooms: 55 Number of comprehensive care resident rooms with battery operated smoke detectors: 55 Number of comprehensive care resident rooms with hard wired and/or wireless smoke detectors: 0 Person completing form - EDWARD GO Title - MAINTENANCE SUPERVIS Date form completed - 10/22/2012 Nurse Aide Training Competency Evaluation Program (NATCEP) NATCEP approved: 03/23/2006 NATCEP expires: 04/01/2012 NATCEP banned: YES NATCEP ban expires: 04/28/2013 This facility is a Clinical training site for the following NAT classroom sites: MILLER'S MERRY MANOR Approved: 01/26/2009 Terminated: 04/29/2011 PLYMOUTH COMUNITY SCHOOL CORPORATION Approved: 03/30/2000 Terminated: 04/29/2011 MILLER'S MERRY MANOR Approved: 03/14/1996 Terminated: 04/29/2011 MILLER'S MERRY MANOR Approved: 08/09/1996 Terminated: 04/29/2011 CROSSROADS ACADEMY Approved: 12/07/2010 Terminated: 04/29/2011 Beds # of Medicaid beds (NF): 0 # of Medicare beds (SNF): 17 # of Medicare/Medicaid beds (SNF/NF): 90 Total number of comprehensive care beds: 107 # of non-certified comprehensive care beds: 0 Total number of residential beds: 0 Total number of beds in facility: 107 Facility census: 70 as of: 03/28/2012 Results of Surveys Date of last annual health survey: 03/16/2012 In substantial compliance on most recent annual health survey? NO If no, date facility achieved substantial compliance from annual health survey: 04/14/2012 Currently found in substantial compliance? Yes # of substantiated complaints: current year 0 # of substantiated complaints: previous year 0 # of substantiated complaints: 2 years previous 0 Substandard quality of care designations: 04/29/2011 Immediate jeopardy designations: N/A 04/29/2011 State Licensure Actions Event ID: K27511 Action - Citation / Fine Notice to facility: 05/01/2002 Appeal: 05/20/2002 Action Cease/Recind: 11/08/2002 Case Closed: 11/08/2002 Initial Amount: $2500 Federal Certification Actions Imposed Civil Money Penalty Date Imposed: 04/27/2011 Date Ended: 05/27/2011 Amount proposed per day: 4600 Amount proposed per day: 100 Date terminated from Medicare.Medicaid: N/A MILLER'S MERRY MANOR
CONSUMER REPORT Created on: 01/10/2013 Posted to the Web on: 01/23/2013 Facility ProfileReturn to Search Page