Created on: 07/25/2025
Posted to the Web on: 08/06/2025
Basic Information
FACILITY CONTACT INFORMATION:
Address: 811 E 12TH STREET
City: MISHAWAKA
Telephone: (574) 259-1917
Web Site:
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
LICENSE INFORMATION:
License number: 24-000045-1
License effective date: 09/01/2024
License expiration date: 08/31/2025
Administration and Staff
Administrator: JENNIFER NEELY
Start date: 05/23/2025
Director of Nursing: FAWN UPDIKE
Start date: 06/10/2025
Director of Nursing: KELLY DANTI
Start date: 04/18/2025
Medical director:
Start date: / /
Wound care specialist:
Start date: / /
Infection preventionist:
Start date: / /
Ownership
CURENT OWNERSHIP:
Owning corporation: HENDRICKS COUNTY HOSPITAL
1000 EAST MAIN STREET
DANVILLE IN 46122
Ownership type: OTHER
Officer(s): KEVIN SPEER
ERIN ENGELS
TODD DAVIS
YVONNE CULPEPPER
D. MICHELLE FENOUGHTY
STANTON "STAN" RISSER
LISA IMLAY
GARY EVERLING
MICHAEL KIRSCHNER
TYLER STARKEY
JOHN WAITE
MARK GENTRY
TIM WHICKER
SHANE SOMMERS
NANCY FOSTER
RYAN VAN DONSELAA
WESLEY ROGERS
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: MISHAWAKA OPERATING LLC
Date of last change of ownership: 09/01/2012
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): 87
Number of non-certified comprehensive care beds (State Licensed only): 0
Total number of comprehensive care beds: 87
RESIDENTIAL CARE BEDS:
Total number of residential beds: 0
Total number of beds in facility: 87
CENSUS:
Facility census: 62
As reported by the facility on: 06/08/2021
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 06/08/2021
Residential care beds occupied: 0
As reported by the facility on: 06/08/2021
Alzheimer Beds: 0
Alzheimer Beds Occupied: 0
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: 38
Number of comprehensive care resident rooms with battery
operated smoke detectors: 38
Number of comprehensive care resident rooms
with hard wired and/or wireless smoke detectors: 0
Person completing form - TIM FOUST
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. MAINTENANCE DIRECTOR
Date form completed - 06/12/2025
Nurse Aide Training
NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 02/25/2002
Nurse aide training and competency evaluation program (NATCEP) expires: 04/01/2004
Nurse aide training and competency evaluation program (NATCEP) banned: Yes
Nurse aide training and competency evaluation program (NATCEP) ban expires: 12/24/2022
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites:
MICHIANA HEALTHCARE TRAINING INC
Approved: 03/13/2002
Terminated: 11/14/2007
HAMILTON SCHOOL - HEALTH OCCUPATIONS
Approved: 10/04/1996
Terminated: 11/14/2007
HARTZ CNA TRAINING CENTER
Approved: 09/10/2013
Terminated: 01/15/2018
THE APPRENTICE ACADEMY
Approved: 04/06/2011
Terminated: 01/15/2018
SOUTH BEND COMMUNITY SCHOOL CORP
Approved: 04/06/2011
Terminated: 01/15/2018
ELKHART AREA CAREER CENTER-HEALTH
Approved: 08/13/2012
Terminated: 01/15/2018
IVY TECH COMMUNITY COLLEGE NORTH-CENTRAL
Approved: 05/03/2012
Terminated: 01/15/2018
BRICKYARD HEALTHCARE - TWELFTH STREET CARE CENTER
Approved: 03/10/1998
Terminated: 03/08/2021
GOLDEN LIVING TRAINING CENTER
Approved: 01/28/2013
Terminated: 04/01/2014
GOLDEN LIVING TRAINING CENTER-ELKHART
Approved: 06/11/2014
Terminated: 01/15/2018
EXCEL CNA AND QMA TRAINING CENTER
Approved: 05/05/2020
Terminated: 12/25/2020
LEGACY MEDICAL ACADEMY
Approved: 10/08/2020
Terminated: 12/25/2020
LEGACY MEDICAL ACADEMY
Approved: 09/02/2022
Terminated: 12/25/2020
CARING TOUCH HEALTHCARE ACADEMY
Approved: 05/04/2021
Terminated: 12/23/2020
CARING TOUCH HEALTHCARE ACADEMY
Approved: 02/21/2025
Terminated: N/A
Complaints
NUMBER OF SUBSTANTIATED COMPLAINTS:
Current year: 0
Previous year: 0
2 years previous: 0
Facility Report Card
03/01/2020 Current QTR
12/01/2019 Previous QTR
09/01/2019 Previous QTR
06/01/2019 Previous QTR
Report Card Score
272
191
245
184
Rank of Score
78
91
83
92
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 gridView 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
No
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
Directed Plan of Correction
Date Imposed: 12/22/2023 Date Ended: 12/15/2023
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.
