Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
MUNSTER MED-INN
 
NURSING HOME
SKILLED NURSING FACILITY / NURSING FACILITY DISTINCT PART
Created on: 3/8/2024
 
Posted to the Web on: 3/20/2024
 
 



Basic Information

FACILITY CONTACT INFORMATION:
Address: 7935 CALUMET AVE
City: MUNSTER
Telephone: (219) 836-8300
Web Site:  
 
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
 
LICENSE INFORMATION:
  License number: 24-000056-1
  License effective date: 1/1/2024
  License expiration date: 12/31/2024
 


Administration and Staff

Administrator: SHANIKA R WILLHITE
  Start date: 8/7/2023
 
Director of Nursing: TAMARA WHITE-JONES
  Start date: 5/17/2018
 
Medical director:  
  Start date:   /  /  
 
Wound care specialist:  
  Start date:   /  /  
 
Infection preventionist:  
  Start date:   /  /  
 


Ownership

CURENT OWNERSHIP:
 
Owning corporation: MAJOR HOSPITAL
2451 INTELLPLEX DR
SHELBYVILLE IN 46176
 
Ownership type:  OTHER
 
Officer(s): DANA CALDWELL
            DOUGLAS CARTER
            JEFF BEATY
            JOHN COFFIN
            JAN SANDMAN
            SHERRI TANDY
            STEVE MIRETZKY
            JOHN HORNER
            PAULA GUSTAFSON
            GENE JONES
            SCOTT MILLER
            RALPH MERCURI
            LINDA WESSIC
            ILYA SHUMAN
            ROB KINDER
            DONALD KUMP
 
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: RIVERVIEW HOSPITAL
Date of last change of ownership: 1/1/2014
 


Bed Counts and Census

COMPREHENSIVE CARE BEDS:
Number of Medicaid beds (NF):                     0
Number of Medicare beds (SNF):                    25
Number of Medicare/Medicaid beds (SNF/NF):        200
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     225
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            0
 
Total number of beds in facility:            225
 
CENSUS:
Facility census:  153
As reported by the facility on: 1/2/2024 2
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 1/2/2024 2
 
Residential care beds occupied:  0
As reported by the facility on: 1/2/2024 2
 
Alzheimer Beds:  46
Alzheimer Beds Occupied:  38
As reported by the facility on:   /  /  
 
Ventilator Beds:  0
Ventilator Beds Occupied:  0
As reported by the facility on:   /  /  
 


Sprinklers and Smoke Detectors

This facility is:  
 
Number of comprehensive care resident rooms: 127
Number of comprehensive care resident rooms with battery 
                    operated smoke detectors: 127
Number of comprehensive care resident rooms 
             with hard wired and/or wireless smoke detectors: 0
 
Person completing form - DANIEL BURNS
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. MAINTENANCE DIR
Date form completed - 3/24/2023
 


Nurse Aide Training

NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 3/22/2000
Nurse aide training and competency evaluation program (NATCEP) expires: 4/1/2002
Nurse aide training and competency evaluation program (NATCEP) banned: Yes
Nurse aide training and competency evaluation program (NATCEP) ban expires: 5/17/2023
 
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: 
     MED ED INCORPORATED
         Approved: 5/13/2014
         Terminated: 8/8/2018
     PURDUE UNIV CALUMET/RESOURCE CENTER
         Approved: 9/14/2005
         Terminated: 8/24/2011
     BLUE SKIES HOSPICE INCORPORATED
         Approved: 2/14/2006
         Terminated: 5/5/2021
     SOCKTECH INTERNATIONAL, INC
         Approved: 9/8/2006
         Terminated: 8/24/2011
     SPECIALIZED MEDICAL EDUCATION AND TRAINING
         Approved: 3/16/2001
         Terminated: 8/24/2011
     MED-STAR ACADEMY
         Approved: 4/25/2014
         Terminated: 8/8/2018
     OLYMPIA COLLEGE
         Approved: 12/5/1997
         Terminated: 8/24/2011
     MUNSTER MED-INN
         Approved: 2/10/1998
         Terminated: 5/18/2021
     PREFERRED MEDICAL ACADEMY
         Approved: 10/21/2014
         Terminated: 8/8/2018
     ADONIS COLLEGE OF NURSING
         Approved: 9/28/2016
         Terminated: 8/8/2018
     DESTINY SCHOOL OF NURSING
         Approved: 3/28/2017
         Terminated: 8/8/2018
     DESTINATION UNLIMITED TRAINING CENTER
         Approved: 8/16/2018
         Terminated: 8/8/2018
     HEALTHCARE TRAINING SOLUTIONS
         Approved: 10/23/2018
         Terminated: 5/18/2021
     MED ED INCORPORATED
         Approved: 12/2/2020
         Terminated: 7/17/2020
     DESTINATION UNLIMITED TRAINING CENTER
         Approved: 10/1/2021
         Terminated: 5/18/2021
     HEALTHCARE TRAINING SOLUTIONS
         Approved: 2/17/2023
         Terminated: 5/18/2021
     HOPE EDUCATIONAL TRAINING CENTER
         Approved: 1/23/2024
         Terminated: N/A
     MIDWEST HEALTHCARE CAREER TRAINING AND DEVELOPMENT
         Approved: 10/26/2023
         Terminated: N/A
 


Complaints

NUMBER OF SUBSTANTIATED COMPLAINTS: 
 
  Current year:  0
  Previous year:  0
  2 years previous:  5

 


Facility Report Card



 


 
3/1/2020 Current QTR
12/1/2019 Previous QTR
9/1/2019 Previous QTR
6/1/2019 Previous QTR


Report Card Score
225
204
165
192


Rank of Score
87
89
93
91


Average Score
302
296
295
296


 
*Facility report card scores have not been updated since March 1, 2020 due to changes in the survey process during the ongoing COVID-19 pandemic. 
The facility report card score is calculated four times per calendar year 
for the two most recent nursing home health surveys.  The facility report card score 
also includes all complaint surveys, life safety code surveys, emergency preparedness surveys, 
and any follow-up surveys that occur within the two most recent nursing home health surveys. 
The facility report card score ranges from 500 to 0, with 500 being the best score possible. 
 
View the Scope and Severity grid
 
View the scoring methodology
 



Overview of Survey findings




 
 The Most Recent Set
 2ND Most Recent Set
 3RD Most Recent Set

Immediate Jeopardy
No
No
Yes


 Substandard Quality of Care 
No
No
Yes


Administrator Change
Yes
No
Yes


Owner Change
No
No
No


Number of Substantiated Complaints With Deficiencies
0
0
0


Deficiency Free Standard Health Survey
No
No
No


 
    The term 'Recent Set' referenced above relates to the referenced annual survey,
    and any other surveys performed between it and the previous annual survey.
 

 


Enforcement Actions

 
Federal Certification Actions Imposed
     Directed Plan of Correction
     Date Imposed: 12/1/2022  Date Ended: 11/21/2022
     Civil Money Penalty
     Date Imposed: 11/9/2022  Date Ended: 11/9/2022
     Amount proposed per day: 
 
Date terminated from Medicare/Medicaid: N/A
 


Survey History


    The survey report is not posted until the report has been provided to the facility and their plan of correction submitted and approved.
    The survey report therefore will likely not be posted until four to six weeks after the exit date.
        
    In the grid below click on an event ID that is underlined to see the survey report for that event.


 
Event ID
Survey Type
Exit Date

JSRL11
Complaint, Other
2/29/2024


85IL22
Recertification, Follow Up, Life Safety Code
2/2/2024


85IL12
Recertification, Complaint, Follow Up, State Licensure
12/28/2023


SUSY11
Complaint
12/11/2023


85IL21
Recertification, Life Safety Code
12/8/2023


85IL11
Recertification, Complaint, State Licensure
11/20/2023


QR6Y11
Complaint
9/6/2023


JXSR12
Complaint, Follow Up
7/27/2023


JXSR11
Complaint
6/28/2023


EJ4622
Recertification, Follow Up, Life Safety Code
12/14/2022


EJ4612
Recertification, Follow Up, State Licensure
12/12/2022


EJ4621
Recertification, Life Safety Code
12/6/2022


EJ4611
Recertification, Complaint, State Licensure
11/9/2022


H53212
Complaint, Follow Up
9/13/2022


H53211
Complaint
8/24/2022


7UUV12
Complaint, Follow Up
3/31/2022


7UUV11
Complaint, Other
3/10/2022


IYWI12
Complaint, Follow Up
2/25/2022


IYWI11
Complaint
2/8/2022


X36U11
Other
1/11/2022


49E612
Follow Up, Other
12/10/2021


49E611
Other
12/1/2021


1G8X22
Recertification, Follow Up, Life Safety Code
9/20/2021


1G8X12
Recertification, Complaint, Follow Up, State Licensure
9/14/2021


1G8X21
Recertification, Life Safety Code
8/30/2021


1G8X11
Recertification, Complaint, State Licensure
8/23/2021


I59T11
Complaint
6/10/2021


5ZDH12
Complaint, Follow Up
4/14/2021


5ZDH11
Complaint
4/6/2021


RH9311
Complaint
3/23/2021


 
 


Links and Resources

 
CMS nursing home compare page 
 
    In addition to the information provided on this 
    web site, the Centers for Medicare & Medicaid Services (CMS) has a web site 
    which contains information on every Medicare and Medicaid certified nursing 
    home in the country. The CMS nursing home survey results contain summary information 
    about a facility's noncompliance of regulations regarding the care of residents 
    found in the nursing homes. You can locate nursing homes in your area and find 
    information about compliance with federal regulations.
 
Resources and links to other organizations
 
Choosing a Nursing Home
 
Overview of the Survey Process
 
State Wide Grouping of all Scores
   
Overview of current comprehensive facility scores
   
Spreadsheet of current comprehensive facility names and scores
   
Legal Disclaimer for Long Term Care Reports.