Indiana State Department of Health
Division of Long Term Care
 
CONSUMER REPORT
 
NORTH WOODS VILLAGE
 
NURSING HOME
SKILLED NURSING FACILITY / NURSING FACILITY DISTINCT PART
Created on: 07/25/2025
 
Posted to the Web on: 08/06/2025
 
 



Basic Information

FACILITY CONTACT INFORMATION:
Address: 2233 W JEFFERSON ST
City: KOKOMO
Telephone: (765) 457-9175
Web Site:  
 
NAME CHANGES:
Most recent name change: N/A
Date of most recent name change: N/A
 
LICENSE INFORMATION:
  License number: 25-000064-1
  License effective date: 01/01/2025
  License expiration date: 12/31/2025
 


Administration and Staff

Administrator: STEPHANIE HEAD
  Start date: 05/23/2023
 
Director of Nursing: DEMETRIA WASHINGTON
  Start date: 09/09/2024
 
Medical director: David Sedaghat
  Start date:   /  /  
 
Wound care specialist:  
  Start date:   /  /  
 
Infection preventionist:  
  Start date:   /  /  
 


Ownership

CURENT OWNERSHIP:
 
Owning corporation: HEALTH AND HOSPITAL CORPORATION OF MARION COUNTY
3838 N RURAL ST
INDIANAPOLIS IN 46205
 
Ownership type:  OTHER
 
Officer(s): GREGORY FEHRIBACH
            CHARLES EBERHARDT II
            CARL DRUMMER
            SHELIA GUENIN
            TED NOLTING
            PAUL BABCOCK
            ROBERT LAZARD
            GEETA MANTRAVADI
            MONICA CRAIN
            BEVERLY MUKES-GAITHER
            THOMAS HANIFY
            LISA HARRIS
            DAVID CRABB
            ROBERTY LAZARD
            BRENDA HORN
 
PREVIOUS OWNERSHIP CHANGES:
Name of previous owner: N/A
Date of last change of ownership: N/A
 


Bed Counts and Census

COMPREHENSIVE CARE BEDS:
Number of Medicaid beds (NF):                     0
Number of Medicare beds (SNF):                    17
Number of Medicare/Medicaid beds (SNF/NF):        147
Number of non-certified comprehensive care beds (State Licensed only):     0
Total number of comprehensive care beds:     164
 
RESIDENTIAL CARE BEDS:
 
Total number of residential beds:            0
 
Total number of beds in facility:            164
 
CENSUS:
Facility census:  115
As reported by the facility on: 07/11/2024
 
Number of comprehensive care beds occupied in this facility. 0
As reported by the facility on: 07/11/2024
 
Residential care beds occupied:  0
As reported by the facility on: 07/11/2024
 
Alzheimer Beds:  56
Alzheimer Beds Occupied:  56
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: 164
Number of comprehensive care resident rooms with battery 
                    operated smoke detectors: 164
Number of comprehensive care resident rooms 
             with hard wired and/or wireless smoke detectors: 0
 
Person completing form - STEPHANIE HEAD
Title of the person who completed the sprinkler, smoke detector form submitted to the ISDH. EXECUTIVE DIRECTOR
Date form completed - 04/07/2025
 


Nurse Aide Training

NURSE AIDE TRAINING PROGRAM APPROVALS:
Nurse aide training and competency evaluation program (NATCEP) approved: 03/15/2004
Nurse aide training and competency evaluation program (NATCEP) expires: 04/01/2006
Nurse aide training and competency evaluation program (NATCEP) banned: Yes
Nurse aide training and competency evaluation program (NATCEP) ban expires: 01/10/2026
 
CLINICAL TRAINING SITES:
This facility is a Clinical training site for the following nurse aide training (NAT) classroom sites: 
     STAFFING AND EDUCATION FOR EXCELLENCE
         Approved: 07/28/1999
         Terminated: 06/11/2004
     NORTH WOODS VILLAGE
         Approved: 07/26/2002
         Terminated: 06/11/2004
     ASC TRAINING CENTER
         Approved: 11/18/2020
         Terminated: 01/11/2024
     LEFFLER ACADEMY
         Approved: 05/10/2021
         Terminated: 01/11/2024
     KOKOMO AREA CAREER TRAINING
         Approved: 08/25/2022
         Terminated: 01/11/2024
 


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
127
76
65
110


Rank of Score
96
98
98
97


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
Yes
No


 Substandard Quality of Care 
No
Yes
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
     Civil Money Penalty
     Date Imposed: 01/06/2024  Date Ended: 01/31/2024
     Amount proposed per day: 7885
     Amount proposed per day: 265
 
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

GZNU22
Follow Up, Life Safety Code, Recertification
06/09/2025


GZNU12
Recertification, Follow Up, State Licensure
04/11/2025


GZNU21
Recertification, Life Safety Code
04/09/2025


FLGH11
Complaint
04/03/2025


GZNU11
Recertification, Complaint, State Licensure
03/06/2025


9FZ811
Complaint
10/31/2024


ZHLJ11
Complaint, Other
08/28/2024


UHFE22
Recertification, Follow Up, Life Safety Code
06/17/2024


UHFE12
Recertification, Follow Up, State Licensure
04/19/2024


UHFE21
Recertification, Life Safety Code
04/16/2024


UHFE11
Recertification, State Licensure
03/15/2024


2M3V12
Complaint, Follow Up
02/13/2024


LDRK11
Complaint
01/26/2024


2M3V11
Complaint
01/11/2024


21DF11
Complaint
01/02/2024


HVV211
Complaint
11/01/2023


GO0H11
Complaint
05/18/2023


HQI312
Recertification, Follow Up, State Licensure
02/22/2023


0NQE11
Complaint
02/17/2023


HQI322
Recertification, Follow Up, Life Safety Code
01/30/2023


HQI321
Recertification, Life Safety Code
01/05/2023


HQI311
Recertification, Complaint, State Licensure
12/20/2022


 
 


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.