Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
CASA OF HOBART
 
NURSING HOME
SKILLED NURSING FACILITY / NURSING FACILITY DUALLY CERTIFIED
Created on: 3/8/2024
 
Posted to the Web on: 3/20/2024
 
 



Basic Information

FACILITY CONTACT INFORMATION:
Address: 4410 W 49TH AVE
City: HOBART
Telephone: (219) 947-1507
Web Site:  
 
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
 
LICENSE INFORMATION:
  License number: 23-000366-1
  License effective date: 3/1/2023
  License expiration date: 2/29/2024
 


Administration and Staff

Administrator: CRAIG CLEMONS
  Start date: 4/12/2023
 
Director of Nursing: LAKOKIE BANKS
  Start date: 7/13/2023
 
Medical director: Havishakrishna Sarma
  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: SEBO'S NURSING AND REHABILITATION CENTER LLC
Date of last change of ownership: 3/1/2013
 


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):        138
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     138
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            0
 
Total number of beds in facility:            138
 
CENSUS:
Facility census:  85
As reported by the facility on: 1/3/2024 1
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 1/3/2024 1
 
Residential care beds occupied:  0
As reported by the facility on: 1/3/2024 1
 
Alzheimer Beds:  54
Alzheimer Beds Occupied:  48
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: FULLY SPRINKLERED
 
Number of comprehensive care resident rooms: 71
Number of comprehensive care resident rooms with battery 
                    operated smoke detectors: 0
Number of comprehensive care resident rooms 
             with hard wired and/or wireless smoke detectors: 71
 
  If hard wired and/or wireless smoke detectors are provided in resident's room, do they:
    (A) Provide a visual and audible signal at the nurses'stations that attend each room? - Yes
    (B) Transmit to a central station service - Yes
    (C) Connect to the health facility's fire alarm system - Yes
 
Person completing form - ANGELA PAZERA
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. ADMIN ASSIST
Date form completed - 4/5/2023
 


Nurse Aide Training

NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 3/18/1998
Nurse aide training and competency evaluation program (NATCEP) expires: 4/1/2000
Nurse aide training and competency evaluation program (NATCEP) banned: Yes
Nurse aide training and competency evaluation program (NATCEP) ban expires: 12/11/2025
 
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: 
     ST ANTHONY MEDICAL CENTER, INC
         Approved: N/A
         Terminated: 9/19/2002
     CASA OF HOBART
         Approved: 4/11/1997
         Terminated: 4/24/2023
     TENDER LOVE CNA ACADEMY, LLC
         Approved: 6/19/2014
         Terminated: 7/26/2021
     IVY TECH COMMUNITY COLLEGE
         Approved: 12/2/2013
         Terminated: 7/27/2021
     IVY TECH CORPORATE COLLEGE
         Approved: 1/10/2014
         Terminated: 4/1/2015
     MED ED INCORPORATED
         Approved: 4/3/2012
         Terminated: 7/26/2021
     GARY AREA CAREER CENTER
         Approved: N/A
         Terminated: 12/11/2009
     OLYMPIA COLLEGE
         Approved: 7/29/1996
         Terminated: 9/19/2002
     MJS COLLEGE SCHOOL OF NURSING AND BUSINESS
         Approved: 10/24/2013
         Terminated: 4/30/2019
     HEALTHCARE TRAINING CENTER
         Approved: 3/5/2014
         Terminated: 4/1/2020
     AMBASSADOR NURSES AIDE TRAINING
         Approved: 5/2/2019
         Terminated: 7/27/2021
     A TECH ACADEMY
         Approved: 12/13/2018
         Terminated: 2/26/2019
     TRAVAIL WITH US LLC
         Approved: 8/14/2019
         Terminated: 10/27/2021
     DESTINATION UNLIMITED TRAINING CENTER
         Approved: 10/1/2021
         Terminated: 7/27/2021
     CENTRAL HIGH SCHOOL-SCHOOL CITY OF EAST CHICAGO
         Approved: 4/18/2017
         Terminated: 7/27/2021
     IVY TECH COMMUNITY COLLEGE-LAKE COUNTY
         Approved: 10/23/2020
         Terminated: 7/27/2021
     MIDWEST HEALTHCARE CAREER TRAINING AND DEVELOPMENT
         Approved: 4/26/2021
         Terminated: 7/27/2021
     DESTINATION UNLIMITED TRAINING CENTER
         Approved: 10/1/2021
         Terminated: 7/27/2021
     IN TRAINING COLLEGE OF ADULT EDUCATION
         Approved: 5/13/2021
         Terminated: 7/27/2021
     BEGINNING OF A START TRAINING CENTER
         Approved: 2/9/2022
         Terminated: 7/26/2021
     BRIDGES CAREER ACADEMY
         Approved: 12/30/2020
         Terminated: 7/27/2021
     JASMINE HOME CARE TRAINING PROGRAM, LLC
         Approved: 10/13/2023
         Terminated: 4/4/2023
     IN TRAINING COLLEGE OF ADULT EDUCATION
         Approved: 3/9/2023
         Terminated: 4/24/2023
 


Complaints

NUMBER OF SUBSTANTIATED COMPLAINTS: 
 
  Current year:  0
  Previous year:  0
  2 years previous:  17

 


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
308
347
347
302


Rank of Score
67
51
53
70


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
No


 Substandard Quality of Care 
No
No
No


Administrator Change
Yes
Yes
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
     Civil Money Penalty
     Date Imposed: 11/16/2023  Date Ended: 12/11/2023
     Amount proposed per day: 7885
     Directed Plan of Correction
     Date Imposed: 10/21/2022  Date Ended: 10/31/2022
     Civil Money Penalty
     Date Imposed: 9/27/2022  Date Ended: 9/27/2022
     Amount proposed per day: 
     Directed Plan of Correction
     Date Imposed: 5/14/2022  Date Ended: 5/9/2022
     Civil Money Penalty
     Date Imposed: 4/22/2022  Date Ended: 4/22/2022
     Amount proposed per day: 
     Directed Plan of Correction
     Date Imposed: 4/9/2022  Date Ended: 4/1/2022
     Civil Money Penalty
     Date Imposed: 3/17/2022  Date Ended: 3/17/2022
     Amount proposed per day: 
     Directed Plan of Correction
     Date Imposed: 12/23/2021  Date Ended: 12/14/2021
     Civil Money Penalty
     Date Imposed: 11/30/2021  Date Ended: 11/30/2021
     Amount proposed per day: 
     Directed Plan of Correction
     Date Imposed: 7/27/2021  Date Ended: 8/13/2021
     Discretionary Deny Pay for New Admits
     Date Imposed: 7/27/2021  Date Ended: 8/12/2021
     Civil Money Penalty
     Date Imposed: 7/2/2021  Date Ended: 7/2/2021
     Amount proposed per day: 
     Amount proposed per day: 500
 
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

YO4C12
Complaint, Follow Up
1/31/2024


8GQ311
Complaint
1/31/2024


QDHL21
Complaint, Life Safety Code
1/24/2024


SUDB22
Recertification, Follow Up, Life Safety Code
1/8/2024


YO4C11
Complaint
12/12/2023


SUDB12
Recertification, Complaint, Follow Up, State Licensure
12/12/2023


SUDB21
Recertification, Life Safety Code
11/16/2023


SUDB11
Recertification, Complaint, State Licensure
11/2/2023


5I4V12
Complaint, Follow Up
8/3/2023


NC6611
Complaint
7/31/2023


5I4V11
Complaint
7/6/2023


5P1D12
Complaint, Follow Up
5/11/2023


5P1D11
Complaint
4/19/2023


YCQQ12
Complaint, Follow Up
1/24/2023


YCQQ11
Complaint
12/29/2022


NYVF11
Complaint
12/8/2022


KAF822
Recertification, Follow Up, Life Safety Code
12/8/2022


OS1B12
Complaint, Follow Up
11/28/2022


KAF821
Recertification, Life Safety Code
11/14/2022


OS1B11
Complaint
10/28/2022


KAF812
Recertification, Complaint, Follow Up, State Licensure
10/28/2022


KAF811
Recertification, Complaint, State Licensure
9/27/2022


UTY111
Complaint
8/9/2022


QLT112
Complaint, Follow Up
8/9/2022


QLT111
Complaint, Other
6/17/2022


NJVX12
Complaint, Follow Up
5/20/2022


NJVX11
Complaint
4/22/2022


8UWM12
Complaint, Follow Up, Other
4/19/2022


8UWM11
Complaint, Other
3/17/2022


0F3U21
Life Safety Code, Other
2/23/2022


JVPH11
Other
1/3/2022


T2ZL12
Follow Up, Other
12/29/2021


T2ZL11
Complaint, Other
11/30/2021


E4Q312
Complaint, Follow Up
9/9/2021


E4Q311
Complaint
8/12/2021


F4R212
Recertification, Complaint, Follow Up, State Licensure
8/12/2021


F4R222
Recertification, Follow Up, Life Safety Code
8/11/2021


F4R221
Recertification, Life Safety Code
7/14/2021


F4R211
Recertification, Complaint, State Licensure
7/2/2021


TBNK11
Other
4/28/2021


PTHC12
Complaint, Follow Up
4/27/2021


PTHC11
Complaint
3/31/2021


 
 


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.