Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
 
THIS FACILITY HAS CLOSED
 
HEALTHCARE CENTER AT WITTENBERG VILLAGE
 
NURSING HOME
SKILLED NURSING FACILITY / NURSING FACILITY DISTINCT PART
Created on: 02/10/2023
 
Posted to the Web on: 02/22/2023
 
 



Basic Information

FACILITY CONTACT INFORMATION:
Address: 1200 E LUTHER DR
City: CROWN POINT
Telephone: (219) 663-3860
Web Site:  
 
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
 
LICENSE INFORMATION:
  License number: 22-000515-1
  License effective date: 08/01/2022
  License expiration date: 07/31/2023
 


Administration and Staff

Administrator: AMY S MAURICE
  Start date: 01/22/2022
 
Director of Nursing: TERESA VERCEL
  Start date: 05/06/2021
 
Medical director: Rajarajeswari Majety
  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:  NON-PROFIT
 
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
 
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: WITTENBERG LUTHERAN VILLAGE INC
Date of last change of ownership: 08/01/2017
 


Bed Counts and Census

COMPREHENSIVE CARE BEDS:
Number of Medicaid beds (NF):                     0
Number of Medicare beds (SNF):                    27
Number of Medicare/Medicaid beds (SNF/NF):        128
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     155
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            0
 
Total number of beds in facility:            155
 
CENSUS:
Facility census:  91
As reported by the facility on: 07/04/2022
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 07/04/2022
 
Residential care beds occupied:  0
As reported by the facility on: 07/04/2022
 
Alzheimer Beds:  27
Alzheimer Beds Occupied:  22
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: 98
Number of comprehensive care resident rooms with battery 
                    operated smoke detectors: 98
Number of comprehensive care resident rooms 
             with hard wired and/or wireless smoke detectors: 0
 
Person completing form - MICHAEL R. MILLER
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. FACILITY DIRECTOR
Date form completed - 02/17/2020
 


Nurse Aide Training

NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 03/12/1996
Nurse aide training and competency evaluation program (NATCEP) expires: 04/01/1998
Nurse aide training and competency evaluation program (NATCEP) banned: Yes
Nurse aide training and competency evaluation program (NATCEP) ban expires: 09/02/2016
 
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: 
     IN TRAINING COLLEGE OF ADULT EDUCATION
         Approved: 10/28/2016
         Terminated: N/A
     LOWELL HIGH SCHOOL
         Approved: 06/28/2018
         Terminated: N/A
     HEALTHCARE CENTER AT WITTENBERG VILLAGE
         Approved: N/A
         Terminated: 09/03/2014
     MED-STAR ACADEMY
         Approved: 07/18/2014
         Terminated: 09/03/2014
     SPECIALIZED MEDICAL EDUCATION AND TRAINING
         Approved: 07/05/2012
         Terminated: 09/03/2014
     MED ED INCORPORATED
         Approved: 10/24/2019
         Terminated: N/A
     IVY TECH COMMUNITY COLLEGE
         Approved: 02/12/2019
         Terminated: N/A
     UNIVERSITY OF SAINT FRANCIS
         Approved: 05/03/2019
         Terminated: 09/03/2022
     TENDER LOVE CNA ACADEMY, LLC
         Approved: 09/06/2019
         Terminated: N/A
     1ST IN CLASS CLINICAL EDUCATION
         Approved: 03/28/2019
         Terminated: N/A
     DESTINATION UNLIMITED TRAINING CENTER
         Approved: 10/01/2021
         Terminated: N/A
     IVY TECH COMMUNITY COLLEGE-LAKE COUNTY
         Approved: 10/23/2020
         Terminated: N/A
     MERRILLVILLE HIGH SCHOOL
         Approved: 03/01/2022
         Terminated: N/A
 


Complaints

NUMBER OF SUBSTANTIATED COMPLAINTS: 
 
  Current year:  0
  Previous year:  1
  2 years previous:  0

 


Enforcement Actions

 
Federal Certification Actions Imposed
     Directed Plan of Correction
     Date Imposed: 01/29/2022  Date Ended: 01/28/2022
     Civil Money Penalty
     Date Imposed: 01/10/2022  Date Ended: 01/10/2022
     Amount proposed per day: 1500
     Civil Money Penalty
     Date Imposed: 01/06/2022  Date Ended: 01/06/2022
     Amount proposed per day: 
     Civil Money Penalty
     Date Imposed: 06/21/2021  Date Ended: 06/21/2021
     Amount proposed per day: 1000
     Directed Plan of Correction
     Date Imposed: 05/18/2021  Date Ended: 05/27/2021
     Civil Money Penalty
     Date Imposed: 04/23/2021  Date Ended: 04/23/2021
     Amount proposed per day: 
 
Date terminated from Medicare/Medicaid: 09/03/2022
 


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

B6CQ22
Recertification, Follow Up, Life Safety Code
09/06/2022


NUYY11
Complaint
09/01/2022


B6CQ12
Recertification, Follow Up, State Licensure
07/19/2022


B6CQ21
Recertification, Life Safety Code
07/18/2022


B6CQ11
Recertification, State Licensure
06/17/2022


61BU12
Complaint, Follow Up, Other
06/03/2022


61BU11
Complaint, Other
04/29/2022


Y70112
Follow Up, Other
02/07/2022


Y70111
Other
01/06/2022


PPZ811
Complaint
12/02/2021


SDF311
Complaint, Other
10/25/2021


ULYG11
Other
09/13/2021


P9QD22
Recertification, Follow Up, Life Safety Code
06/03/2021


P9QD12
Recertification, Follow Up, State Licensure
05/28/2021


P9QD21
Recertification, Life Safety Code
04/27/2021


P9QD11
Recertification, State Licensure
04/23/2021


841G11
Complaint
02/10/2021


B22111
Complaint, Other
11/09/2020


FS1E11
Other
10/21/2020


YMP411
Complaint
09/24/2020


OBCG11
Complaint
08/18/2020


091Q11
Other
05/20/2020


 
 


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.